TY - JOUR
T1 - Identification of patients who may benefit the most from adjuvant chemotherapy following resection of incidental gallbladder carcinoma
AU - Xiang, Jun Xi
AU - Zhang, Xu Feng
AU - Weber, Sharon M.
AU - Poultsides, George
AU - Fields, Ryan C.
AU - Hatzaras, Ioannis
AU - Weiss, Matthew
AU - Scoggins, Charles
AU - Idrees, Kamron
AU - Shen, Perry
AU - Maithel, Shishir K.
AU - Pawlik, Timothy M.
N1 - Publisher Copyright:
© 2021 Wiley Periodicals LLC
PY - 2021/3/15
Y1 - 2021/3/15
N2 - Background: To develop a scoring system to identify the subset of patients who may benefit the most from adjuvant chemotherapy following curative-intent resection for incidental gallbladder cancer (IGBC). Methods: A novel scoring system was utilized to stratify patients relative to overall survival (OS), as well as potential benefit from adjuvant chemotherapy following curative resection for IGBC. Results: Among 266 patients with IGBC, a total of 99 (37.2%) patients received adjuvant chemotherapy. Five risk factors were used to develop an integer-based score to predict OS. Risk of death at 5-years incrementally increased among patients in the low (n = 42, 69.0%), medium (n = 64, 56.3%) and high-risk groups (n = 40, 30.0%) (median OS, 99.4 vs. 33.5 vs. 15.6 months, all p <.001). Use of adjuvant chemotherapy did not provide a survival benefit among patients in the low-risk group (median survival, 99.4 vs. 60.7 months, p =.56). In contrast, utilization of adjuvant chemotherapy was associated with an improvement in survival among medium- (median survival, 21.7 vs. 59.5 months, p =.04) and high-risk patients (median survival, 11.6 vs. 20.1 months, p =.01). Conclusions: While low-risk patients did not benefit from adjuvant chemotherapy, individuals with medium or high-risk scores had an improved survival with the utilization of adjuvant chemotherapy.
AB - Background: To develop a scoring system to identify the subset of patients who may benefit the most from adjuvant chemotherapy following curative-intent resection for incidental gallbladder cancer (IGBC). Methods: A novel scoring system was utilized to stratify patients relative to overall survival (OS), as well as potential benefit from adjuvant chemotherapy following curative resection for IGBC. Results: Among 266 patients with IGBC, a total of 99 (37.2%) patients received adjuvant chemotherapy. Five risk factors were used to develop an integer-based score to predict OS. Risk of death at 5-years incrementally increased among patients in the low (n = 42, 69.0%), medium (n = 64, 56.3%) and high-risk groups (n = 40, 30.0%) (median OS, 99.4 vs. 33.5 vs. 15.6 months, all p <.001). Use of adjuvant chemotherapy did not provide a survival benefit among patients in the low-risk group (median survival, 99.4 vs. 60.7 months, p =.56). In contrast, utilization of adjuvant chemotherapy was associated with an improvement in survival among medium- (median survival, 21.7 vs. 59.5 months, p =.04) and high-risk patients (median survival, 11.6 vs. 20.1 months, p =.01). Conclusions: While low-risk patients did not benefit from adjuvant chemotherapy, individuals with medium or high-risk scores had an improved survival with the utilization of adjuvant chemotherapy.
KW - adjuvant chemotherapy incidental gallbladder carcinoma
KW - scoring system
KW - survival benefit
UR - http://www.scopus.com/inward/record.url?scp=85099968927&partnerID=8YFLogxK
U2 - 10.1002/jso.26389
DO - 10.1002/jso.26389
M3 - Article
C2 - 33497466
AN - SCOPUS:85099968927
SN - 0022-4790
VL - 123
SP - 978
EP - 985
JO - Journal of surgical oncology
JF - Journal of surgical oncology
IS - 4
ER -