Comparative Analysis Of The Effect Of Postoperative Chemotherapy, Radiotherapy And Chemoradiotherapy In Gallbladder Cancer

Objective: The indications of postoperative adjuvant therapy in Gallbladder cancer (GBC) have not been determined yet. The aims of our study are to analyze the effect of postoperative adjuvant therapy for patients with GBC, according to TNM stage and try to determine the indications of postoperative adjuvant therapy in GBC.Methods: We retrospectively reviewed the medical records of patients who had been diagnosed with GBC and undergone surgery between September1,2000and October31,2013. Overall survival (OS) results were determined by phone call follow-up. The OS of patients were comparatively analyzed according to TNM stage and postoperative adjuvant therapy.Results:161patients with GBC at Stage II (T2N0M0), Stage IIIA (T3N0M0), Stage ⅢB (T1-3N1M0) and Stage IVB (T1-4N2M0/T1-4N1-2M1) were enrolled. Among the four stages, Stage Ⅱ did not show any gain in OS by adding postoperative adjuvant therapy. Neither postoperative CT nor RT conferred OS benefit on patients with Stage ⅢA, however postoperative CRT conferred OS benefit on patients with Stage IIIA. Both postoperative CT and CRT conferred OS benefit on patients with stage ⅢB, and the effects of postoperative CT and CRT were similar. All of the postoperative adjuvant therapy conferred OS benefit on patients with stage IVB, and the effects of postoperative CT, RT and CRT were similar.Conclusions: Postoperative adjuvant CT, RT and CRT are recommended for lymph node Metastasis or distant metastasis (Stage IIIB, IVB) GBC underwent surgical resection, and the effects of the three kinds of postoperative adjuvant therapy are similar. Postoperative adjuvant CRT is recommended for lymph node-negative T3classification (Stage IIIA).