title: Adjuvant radiation therapy is associated with improved survival for gallbladder carcinoma with regional metastatic disease.
abstract: BACKGROUND
  Gallbladder carcinoma is a rare malignancy and is associated with dismal outcomes. The aim of this study was to better define the role of adjuvant radiation therapy in the management of gallbladder carcinoma.
  
  
  METHODS
  The Surveillance, Epidemiological, and End Results (SEER) survey from the National Cancer Institute was queried from 1992 to 2002. Retrospective analysis was done. The end-point of the study was overall survival.
  
  
  RESULTS
  There were a total of 3,187 cases of gallbladder carcinoma in the registry from 1992 to 2002. Of the surgical group, 35% were stage I, 36% were stage II, 6% were stage III, and 21% were stage IV. Adjuvant radiation was used in 17% of the cases. The median survival for those patients receiving adjuvant radiation therapy was 14 months compared to an 8 months median survival for those treated without adjuvant radiation therapy (P < or = 0.001). The survival benefit associated with radiation use was only presenting those patients with regional spread (P = 0.0001) and tumors infiltrating the liver (P = 0.011).
  
  
  CONCLUSIONS
  The use of adjuvant radiation therapy is associated with improved survival in patients with locally advanced gallbladder cancer or gallbladder cancer with regional disease.
authors.affiliation: Division of Surgery, City of Hope National Medical Center, Duarte, California 91010, USA.
authors.forename: Pablo
authors.initials: P
authors.lastname: Mojica
authors.forename: David
authors.initials: D
authors.lastname: Smith
authors.forename: Joshua
authors.initials: J
authors.lastname: Ellenhorn
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy; D015331:Cohort Studies; D005260:Female; D005706:Gallbladder Neoplasms / Q000453:epidemiology / Q000401:mortality* / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012042:Registries / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018426:SEER Program; D016019:Survival Analysis