Survival benefit of adjuvant radiotherapy for gallbladder cancer patients with stage IIIA: a population based, propensity score-matched study.

BACKGROUND

The optimal adjuvant treatment for advanced gallbladder cancer (GBC) remains controversial. This study aimed to evaluate whether adjuvant radiotherapy (ART) after surgery confers a survival benefit in patients with advanced GBC, particularly focusing on stage IIIA disease.

METHODS

We retrospectively analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database (January 2010-December 2015). Patients were divided into ART and non-ART groups. Overall survival (OS) and cancer-specific survival (CSS) were evaluated using Cox proportional hazards models and Kaplan-Meier curves, with 95% confidence intervals (CIs). Propensity score matching (PSM) was applied to minimize baseline confounding.

RESULTS

A total of 2,012 eligible patients were included: 430 (21.4%) received ART, while 1,582 (78.6%) did not. After PSM, 376 matched pairs were analyzed. ART was associated with significantly improved OS [hazard ratio (HR) =0.75, 95% CI: 0.64-0.89, P<0.001] and CSS (HR =0.73, 95% CI: 0.60-0.87, P<0.001). In Subgroup Analysis, ART conferred a significant survival benefit specifically in patients with stage IIIA GBC [OS (HR =0.56, 95% CI: 0.41-0.77, P<0.001) and CSS (HR =0.54, 95% CI: 0.37-0.75, P<0.001)], whereas no significant benefit was observed for stages IIIB, IVA, or IVB.

CONCLUSIONS

Our findings from this large, population-based cohort suggest that ART, may improve survival in patients with stage IIIA GBC.