Adjuvant chemoradiation in resected gallbladder cancer: a prognostic index model for predicting overall survival
Patients with gallbladder cancer (GBC) have a dismal prognosis. We investigated outcomes and risk factors for overall survival (OS) in patients treated with radical surgery and adjuvant chemoradiotherapy (CRT).
A total of 212 patients with LAGC (⩾pT3 59% and/or pN+ 52%) were studied. The primary endpoint of the analysis was OS. We constructed a risk scoring system in which points were assigned to each risk factor by dividing each β coefficient in the final model by the lowest β coefficient and rounding to the nearest integer. A risk score was assigned to each subject by adding up the points for each risk factor present. Subjects were then divided into three risk groups based on their risk scores (0 points = low risk, 1–2 points = intermediate risk, 3–6 points = high risk).
Median follow-up was 46.2 months (2–235). Five-year OS for the entire cohort was 53%. In multivariate analysis, higher pT stage [HR, 2.43 (1.29–3.68); p = 0.01], R1 resection [HR, 5.06 (3.12–8.19); p < 0.001], and number of surgical procedures [HR, 1.41 (1.01–2.16); p = 0.05] were associated with an increased risk of death. Five-year OS for patients with low (n = 63), intermediate (n = 94), and high (n = 55) risk was 79.1%, 51.2%, and 9.5%, respectively.
Overall results after multimodality treatment of GBC are promising. A risk model was generated to determine a prognostic index for individual patients with GBC. Classification of risk factors for death has contributed to propose a prognostic index that could allow us to guide risk-adapted tailored treatment.
KeywordsGallbladder cancer Radiotherapy Overall survival
Compliance with ethical standards
No funding was received for this study.
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in the study were in accordance with the ethical standards of the national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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