한국간담췌외과학회지 (Annals of Hepato-Biliary-Pancreatic Surgery)

  • 제15권1호
  • /
  • Pages.35-41
  • /
  • 2011
  • /
  • 2508-5778(pISSN)
  • /
  • 2508-5859(eISSN)
한국간담췌외과학회 (The Korean Association of Hepato-Biliary-Pancreatic Surgery)
권호 표지

The Effect of Adjuvant Radiotherapy in Patients Undergoing Complete Resection for Gallbladder Cancer with Lymph Node Metastasis

  • Lee, Jae Myeong (Department of Anesthesiology and Pain Medicine, Ajou University School of Medicine) ;
  • Kang, Seung-Hee (Department of Radiation Oncology, Ilsan-Paik Hospital Inje University School of Medicine) ;
  • Kim, Bong Wan (Department of Surgery, Ajou University School of Medicine) ;
  • Wang, Hee Jung (Department of Surgery, Ajou University School of Medicine) ;
  • Chun, Mison (Department of Radiation Oncology, Ajou University School of Medicine) ;
  • Kim, Myung Wook (Department of Surgery, Ajou University School of Medicine)
  • 발행 : 2011.02.28
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: We evaluated the effect of adjuvant radiotherapy on survival in patients who underwent curative resection for gallbladder cancer with lymph node metastasis. Methods: Among the patients underwent curative resection even though there was lymph node metastasis; fifteen patients underwent adjuvant radiotherapy with over 40 Gy (RTx group) and 10 patients did not (no RTx group). We compared these two groups retrospectively. Results: The median disease free survival (DFS) of the RTx group (21.6 months) was longer than for the no RTx group (6.6 months, p=0.451). The median overall survival (OS) of the RTx group (30.5 months) was also longer than the no RTx group (14.2 months). One-, 2-, and 5-yr OS rates were 60.0%, 40.0% and 40.0% in the no RTx group, and 86.7%, 70.9% and 26.6% in the RTx group, respectively (p=0.507). Five patients developed recurrence within 1 year (50.0%) in the no RTx group; there were 3 (20.0%) in the RTx group. Conclusion: Our study was limited by its retrospective nature and small numbers of patients. However, it suggests that adjuvant radiotherapy might improve DFS and OS for patients with completely resected but lymph node metastasized gallbladder cancer. Also this therapy seems to delay time to postoperative recurrence.

키워드

참고문헌

  1. Gourgiotis S, Kocher HM, Solaini L, Yarollahi A, Tsiambas E, Salemis NS. Gallbladder cancer. Am J Surg 2008;196: 252-264. https://doi.org/10.1016/j.amjsurg.2007.11.011
  2. Reid KM, Ramos-De la Medina A, Donohue JH. Diagnosis and surgical management of gallbladder cancer: a review. J Gastrointest Surg 2007;11:671-681. https://doi.org/10.1007/s11605-006-0075-x
  3. Duffy A, Capanu M, Abou-Alfa GK, et al. Gallbladder cancer (GBC): 10-year experience at Memorial Sloan-Kettering Cancer Centre (MSKCC). J Surg Oncol 2008;98:485-489. https://doi.org/10.1002/jso.21141
  4. Mahantshetty UM, Palled SR, Engineer R, Homkar G, Shrivastava SK, Shukla PJ. Adjuvant radiation therapy in gall bladder cancers: 10 years experience at Tata Memorial Hospital. J Cancer Res Ther 2006;2:52-56. https://doi.org/10.4103/0973-1482.25850
  5. Kresl JJ, Schild SE, Henning GT, et al. Adjuvant external beam radiation therapy with concurrent chemotherapy in the management of gallbladder carcinoma. Int J Radiat Oncol Biol Phys 2002;52:167-175. https://doi.org/10.1016/S0360-3016(01)01764-3
  6. Czito BG, Hurwitz HI, Clough RW, et al. Adjuvant external-beam radiotherapy with concurrent chemotherapy after resection of primary gallbladder carcinoma: a 23-year experience. Int J Radiat Oncol Biol Phys 2005;62:1030-1034. https://doi.org/10.1016/j.ijrobp.2004.12.059
  7. Gold DG, Miller RC, Haddock MG, et al. Adjuvant therapy for gallbladder carcinoma: the Mayo Clinic Experience. Int J Radiat Oncol Biol Phys 2009;75:150-155. https://doi.org/10.1016/j.ijrobp.2008.10.052
  8. Houry S, Barrier A, Huguier M. Irradiation therapy for gallbladder carcinoma: recent advances. J Hepatobiliary Pancreat Surg 2001;8:518-524. https://doi.org/10.1007/s005340100019
  9. de Aretxabala X, Roa I, Berrios M, et al. Chemoradiotherapy in gallbladder cancer. J Surg Oncol 2006;93:699-704. https://doi.org/10.1002/jso.20538
  10. Misra S, Chaturvedi A, Misra NC, Sharma ID. Carcinoma of the gallbladder. Lancet Oncol 2003;4:167-176. https://doi.org/10.1016/S1470-2045(03)01021-0
  11. Wang SJ, Fuller CD, Kim JS, Sittig DF, Thomas CR Jr, Ravdin PM. Prediction model for estimating the survival benefit of adjuvant radiotherapy for gallbladder cancer. J Clin Oncol 2008;26:2112-2117. https://doi.org/10.1200/JCO.2007.14.7934
  12. Yoshimitsu K, Honda H, Kuroiwa T, et al. Liver metastasis from gallbladder carcinoma: anatomic correlation with cholecystic venous drainage demonstrated by helical computed tomography during injection of contrast medium in the cholecystic artery. Cancer 2001;92:340-348. https://doi.org/10.1002/1097-0142(20010715)92:2<340::AID-CNCR1328>3.0.CO;2-5
  13. Smoron GL. Radiation therapy of carcinoma of gallbladder and biliary tract. Cancer 1977;40:1422-1424. https://doi.org/10.1002/1097-0142(197710)40:4<1422::AID-CNCR2820400410>3.0.CO;2-1
  14. Kopelson G, Harisiadis L, Tretter P, Chang CH. The role of radiation therapy in cancer of the extra-hepatic biliary system: an analysis of thirteen patients and a review of the literature of the effectiveness of surgery, chemotherapy and radiotherapy. Int J Radiat Oncol Biol Phys 1977;2:883-894. https://doi.org/10.1016/0360-3016(77)90186-9
  15. Balachandran P, Agarwal S, Krishnani N, et al. Predictors of long-term survival in patients with gallbladder cancer. J Gastrointest Surg 2006;10:848-854. https://doi.org/10.1016/j.gassur.2005.12.002
  16. Mojica P, Smith D, Ellenhorn J. Adjuvant radiation therapy is associated with improved survival for gallbladder carcinoma with regional metastatic disease. J Surg Oncol 2007;96:8-13. https://doi.org/10.1002/jso.20831
  17. Ong SL, Garcea G, Thomasset SC, et al. Ten-year experience in the management of gallbladder cancer from a single hepatobiliary and pancreatic centre with review of the literature. HPB (Oxford) 2008;10:446-458. https://doi.org/10.1080/13651820802392346
  18. Kayahara M, Nagakawa T, Nakagawara H, Kitagawa H, Ohta T. Prognostic factors for gallbladder cancer in Japan. Ann Surg 2008;248:807-814. https://doi.org/10.1097/SLA.0b013e31818a1561
  19. Manfredi S, Benhamiche AM, Isambert N, Prost P, Jouve JL, Faivre J. Trends in incidence and management of gallbladder carcinoma: a population-based study in France. Cancer 2000;89:757-762. https://doi.org/10.1002/1097-0142(20000815)89:4<757::AID-CNCR6>3.0.CO;2-H
  20. Kraybill WG, Lee H, Picus J, et al. Multidisciplinary treatment of biliary tract cancers. J Surg Oncol 1994;55:239-245. https://doi.org/10.1002/jso.2930550408
  21. Houry S, Schlienger M, Huguier M, Lacaine F, Penne F, Laugier A. Gallbladder carcinoma: role of radiation therapy. Br J Surg 1989;76:448-450. https://doi.org/10.1002/bjs.1800760508
  22. Bosset JF, Mantion G, Gillet M, et al. Primary carcinoma of the gallbladder. Adjuvant postoperative external irradiation. Cancer 1989;64:1843-1847. https://doi.org/10.1002/1097-0142(19891101)64:9<1843::AID-CNCR2820640915>3.0.CO;2-N
  23. Jarnagin WR, Ruo L, Little SA, et al. Patterns of initial disease recurrence after resection of gallbladder carcinoma and hilar cholangiocarcinoma: implications for adjuvant therapeutic strategies. Cancer 2003;98:1689-1700. https://doi.org/10.1002/cncr.11699