| Ye Shuang,Bei Yanping,Zhang Hui,Zheng Lu,Chen Xue,Liu Kaitai.Impacts of postoperative radiotherapy on long-term survival of patients with locally advanced biliary tract cancers——a propensity score-matched analysis based on the SEER database[J].Chinese Journal of Radiological Medicine and Protection,2021,41(9):665-671 |
| Impacts of postoperative radiotherapy on long-term survival of patients with locally advanced biliary tract cancers——a propensity score-matched analysis based on the SEER database |
| Received:January 12, 2021 |
| DOI：10.3760/cma.j.issn.0254-5098.2021.09.005 |
| KeyWords:Biliary tract cancers Postoperative radiotherapy Cancer-specific survival(CSS) Epidemiology and End Results(SEER) database |
| FundProject:浙江省自然科学基金（LY21H160013）；浙江省医药卫生科技项目（2020KY275） |
| Author Name | Affiliation | E-mail | | Ye Shuang | Department of Radiation Oncology, Lihuili Hospital of Ningbo Medical Center, Ningbo 315040, China | | | Bei Yanping | Department of Radiation Oncology, Lihuili Hospital of Ningbo Medical Center, Ningbo 315040, China | | | Zhang Hui | Department of Radiation Oncology, Lihuili Hospital of Ningbo Medical Center, Ningbo 315040, China | | | Zheng Lu | Department of Radiation Oncology, Lihuili Hospital of Ningbo Medical Center, Ningbo 315040, China | | | Chen Xue | Department of Radiation Oncology, Lihuili Hospital of Ningbo Medical Center, Ningbo 315040, China | | | Liu Kaitai | Department of Radiation Oncology, Lihuili Hospital of Ningbo Medical Center, Ningbo 315040, China | lkt1982@126.com |
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| Abstract:: |
| Objective To explore the impacts of postoperative radiotherapy on long-term survival of the patients with resectable locally advanced (T3-4and/or N+) biliary tract cancers (BTCs) and to analyze the prognostic factors. Methods The patients with locally advanced gallbladder cancer (n=1 922) and the patients with extrahepatic biliary duct cancer (n=3 408) who received surgical resection during 2006-2016 were selected from the Surveillance, Epidemiology, and End Result (SEER) database. They were grouped according to different treatment schemes (only surgery and surgery + radiation). The propensity score matching (PSM) method was employed to adjust the differences in baseline prognostic characteristics between patients who received only surgery and those treated with surgery+ radiation. The role of the two treatment schemes on the survival of the patients was analyzed using the Kaplan-Meier method and the prognosis factors were assessed using the Cox regression. Results The 1 174 patients with gallbladder cancers and the 2 144 patients with extrahepatic biliary duct cancer were respectively matched according to propensity scores. The postoperative radiotherapy showed a significant advantage in 5-year cancer-specific survival (CSS) compared to only surgery for both the patients with gallbladder cancer (χ2=35.73, P< 0.001) and those with extrahepatic biliary duct cancer (χ2=9.878, P=0.002). After adjusting related covariates, independent prognostic factors for all the patients included pathological grading, T status, N status, treatment pattern, and age. For the patients with extrahepatic biliary duct cancer, independent prognostic factors also included race and year of diagnosis. The benefits of postoperative radiotherapy were observed in various clinicopathologic characteristics except for the patients with T1-2 gallbladder cancer and the extrahepatic biliary duct cancer patients with a pathological grade of Ⅰ-Ⅱ and N0 status or with age ≥ 70. Conclusions Long-term survival benefits can be gained through postoperative radiotherapy for the patients with resectable locally advanced (T3-4 and/or N+) BTCs. However, adjuvant radiation should be cautiously adopted for the patients with T1-2 gallbladder cancer and the extrahepatic biliary duct cancer patients with a pathological grade of I-Ⅱ and N0 status or with age ≥ 70. |
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