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Role of Peri-operative Chemotherapy in Stage II (pT2N0) Gallbladder Cancers

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Evidence for adjuvant chemotherapy in gallbladder cancer (GBC) is conflicting, with a postulated beneficial effect reported in T2 stage or higher, and node-positive tumours. This study aims to assess the survival benefit of peri-operative chemotherapy in stage II (pT2N0) GBCs.

Methods

A retrospective analysis of stage II GBCs who underwent curative surgical resection was done. Patients receiving neo-adjuvant therapy (NACT) prior to resection of the gallbladder primary were excluded. Primary endpoint was disease-free survival, and outcomes of patients who received chemotherapy were compared to those who did not. Survival curves were plotted using a Kaplan–Meier analysis and difference between the survival curves was analysed using a log-rank test.

Results

Two hundred seventy-six patients of stage II GBC were included, of whom 188 (68.1%) received chemotherapy and 88 (31.8%) did not. Forty-one (21.8%) patients received chemotherapy in the neo-adjuvant setting. There was no significant difference in the survival of patients who did and did not receive chemotherapy (5-year DFS 67.8% vs 66%, p = 0.795). There was no significant difference in the survival of patients who received chemotherapy in the adjuvant or neo-adjuvant setting (5-year DFS 66.4% vs 71.8%, p = 0.541). There was no statistically significant difference in the survival of patients with high-risk histologic features and who did and did not receive chemotherapy (3-year DFS 72.4% vs 56%; p = 0.379).

Conclusions

Routine use of chemotherapy, either in the adjuvant or neo-adjuvant setting, offers no survival advantage in stage II (pT2N0) gallbladder cancers.

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Authors and Affiliations

  1. GI & HPB Services, Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, 1213, Homi Bhabha Block, Dr. Ernest Borges Road, Parel East, Mumbai, 400012, India

    Aditya Kunte, Shraddha Patkar, Vikram Chaudhari & Mahesh Goel

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  1. Aditya Kunte
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  2. Shraddha Patkar
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  3. Vikram Chaudhari
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  4. Mahesh Goel
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Contributions

Conception of the study design was done by MG, SP, and VC. Acquisition of data, data analysis, and drafting of the manuscript were done by AK. Critical revision of the manuscript was done by MG, SP, and VC. Final approval of the manuscript was done by MG, SP, and VC.

Corresponding author

Correspondence to Mahesh Goel.

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This study was performed in accordance with the revised Helsinki declaration (2013) and after obtaining approval from the institutional ethics committee.

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The authors declare no competing interests.

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Kunte, A., Patkar, S., Chaudhari, V. et al. Role of Peri-operative Chemotherapy in Stage II (pT2N0) Gallbladder Cancers. J Gastrointest Surg 27, 78–88 (2023). https://doi.org/10.1007/s11605-022-05495-7

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  • DOI: https://doi.org/10.1007/s11605-022-05495-7

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