Adjuvant treatment for the elderly patient with resected gallbladder cancer: a SEER-Medicare analysis

被引:3
作者
Lohman, Elise de Savornin [1 ,2 ]
Belkouz, Ali [3 ]
Nuliyalu, Usha [2 ]
Koerkamp, Bas Groot [4 ]
Klumpen, Heinz-Josef [3 ]
de Reuver, Philip [1 ]
Nathan, Hari [2 ]
机构
[1] Radboudumc, Dept Surg, Geert Grootepl Zuid 10, NL-6525 GA Nijmegen, Netherlands
[2] Univ Michigan, Dept Surg, 1500 E Med Ctr Dr, Ann Arbor, MI 48109 USA
[3] Univ Amsterdam, Dept Med Oncol, Med Ctr, 9, NL-1105 AZ Amsterdam, Netherlands
[4] Erasmus MC Canc Inst, Dept Surg, Doctor M Olewaterpl 40, NL-3015 GD Rotterdam, Netherlands
关键词
Gallbladder cancer (GBC); chemotherapy; survival; elderly; BILIARY-TRACT CANCERS; COMORBIDITY MEASURES; GEMCITABINE; ELIXHAUSER; THERAPY; CHOLANGIOCARCINOMA; CHEMORADIOTHERAPY; CHEMOTHERAPY; CARCINOMA; OUTCOMES;
D O I
10.21037/jgo-22-348
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: In patients with resected gallbladder cancer (GBC), the role of adjuvant chemotherapy (aCT) remains ill-defined, especially in elderly patients. This study evaluates the value of aCT in elderly patients with GBC and assesses response according to tumor stage. Methods: Patients of >= 65 years of age with resected GBC diagnosed from 2004-2015 were identified using a Surveillance, Epidemiology and End Results (SEER)/Medicare linked database. After propensity score matching, survival of patients treated with aCT was compared to survival of patients who did not receive aCT using Kaplan-Meier and Cox proportional hazards analysis. Results: Of 2,179 patients with resected GBC, 876 (25%) received aCT. In the full cohort of 810 propensity-score matched patients, survival did not differ between patients treated with aCT (17.6 months ) and without aCT (19.5 months, P=0.7720). Subgroup analysis showed that survival was significantly better after aCT in T3/T4 disease (12.3 vs. 7.2 months, P=0.013). Interaction analysis showed that benefit of aCT was primarily seen in combined T3/T4, node-positive disease (HR 0.612 , P=0.006). Conclusions: In this large cohort of elderly patients with resected GBC, aCT was not associated with increased survival. However, aCT may provide a survival benefit in T3/4, node-positive disease.
引用
收藏
页码:3227 / 3239
页数:16
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