National Cancer Database analysis of gallbladder cancer: Evaluating survival benefit of chemotherapy in early-stage gallbladder cancer.

Abstract

Background: For locally advanced gallbladder cancer, previous clinical studies have demonstrated that chemotherapy results in significant survival benefits when compared to surgery alone. However, data demonstrating a similar survival benefit with early-stage gallbladder cancer is limited. This study seeks to evaluate the impact chemotherapy has on survival in patients with early-stage gallbladder cancer using a large, multi-institution database.

Aim: To investigate the survival benefit of chemotherapy in patients with stage II gallbladder cancer.

Methods: We performed a retrospective multivariable analysis of the National Cancer Database from 2010 to 2017 to evaluate the effect that chemotherapy has on the survival of patients with stage II gallbladder cancer. Our objective was to determine if there were any statistically significant survival differences between those who received surgery and chemotherapy vs those who only underwent surgery.

Results: Of the 899 patients with stage II gallbladder cancer, 328 patients had undergone chemotherapy and surgery. The average overall survival for those who had surgery and chemotherapy vs only surgery was 52.6 months and 51.1 months, respectively. This difference was not statistically significant (P = 0.2). In the secondary analysis, the surgical group who had a liver resection had better overall survival (P < 0.0001).

Conclusion: Practitioners should carefully consider chemotherapy for early-stage gallbladder cancer, as risks may outweigh survival benefits, and surgeons should also consider liver resections as part of their surgical management.