Limited Use of Adjuvant Therapy in Patients With Resected Gallbladder Cancer Despite a Strong Association With Survival
Limited Use of Adjuvant Therapy in Patients With Resected Gallbladder Cancer Despite a Strong Association With Survival
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DOI：
10.1093/jnci/djw324
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发表时间：
2017-07-01
影响因子：
10.3
通讯作者：
Sineshaw, Helmneh M.
中科院分区：
文献类型：
--
作者：
Mitin, Timur;Enestvedt, C. Kristian;Sineshaw, Helmneh M.
背景：没有随机数据指导临床医生治疗胆囊癌（GBC）患者。几项回顾性研究报告了辅助放疗（RT）和放化疗（CRT）的生存获益。在本文中，我们研究这些出版物是否影响了辅助治疗的利用率，以及它们的生存益处是否在当代patients.Methods队列中是显而易见的：使用国家癌症数据库，我们确定了5029例诊断为T1- 3 N 0 -1 GBC的患者，并在2005年至2013年期间接受手术切除治疗。我们描述了三个时间段（2005-2007、2008-2010、2011-2013）接受辅助治疗的趋势，并计算了2005-2010年接受治疗的2989例患者的3年总生存（OS）概率。所有的统计检验都是双侧的。结果：从2005年到2013年，没有接受辅助治疗的患者比例没有变化。辅助RT从4.2%下降到1.7%（P <0.001），辅助化疗从8.3%上升到13.8%（P <0.001）。
Background: There are no randomized data to guide clinicians treating patients with gallbladder cancer (GBC). Several retrospective studies reported the survival benefits of adjuvant radiotherapy (RT) and chemoradiation (CRT). In this paper, we examine whether these publications have impacted the utilization of adjuvant therapies and whether their survival benefits are evident in a contemporary cohort of patients.Methods: Using the National Cancer Data Base, we identified 5029 patients diagnosed with T1-3N0-1 GBC and treated with surgical resection from 2005 to 2013. We described trends in receipt of adjuvant treatments for three time periods (2005-2007, 2008-2010, 2011-2013) and calculated three-year overall survival (OS) probabilities for 2989 patients treated in 2005-2010. All statistical tests were two-sided.Results: The percentage of patients who received no adjuvant treatments was unchanged from 2005 to 2013. Adjuvant RT decreased from 4.2% to 1.7% (P < .001), adjuvant chemotherapy increased from 8.3% to 13.8% (P