BACKGROUND Equipoise exists regarding the benefit of adjuvant therapy (AT) in patients with gallbladder cancer (GBC). The aim of this study was to critically review the available evidence for the effectiveness of AT in patients with GBC following surgery with curative intent. METHODS A systematic review was performed. Relevant studies were identified from Trip Database, BIREME-BVS, SciELO, Cochrane Central Register, WoS, MEDLINE, EMBASE and SCOPUS. Adjuvant therapies considered included chemotherapy, chemoradiotherapy, and radiotherapy. The primary outcome was overall survival (OS). Subgorup analysis of patients with positive lymph node disease (PLND), positive surgical margin (PSM), or advanced stage (AS) were performed. RESULTS 748 related articles were identified; 27 met the selection criteria (3 systematic reviews and 24 observational studies). Evidence provided was moderate, poor and very poor for chemotherapy, chemoradiotherapy, and radiotherapy. Existing evidence is not robust, but suggests certain benefits with AT in improving OS, especially in patients with PLND, PSM and AS. CONCLUSION Results do not provide strong evidence that AT is effective in patients who undergo resection for GBC. Subgroups of PLND and PSM may have a survival advantage. Future studies with appropriate internal validity and adequate number of patients are required to better answer this question.

中文翻译：

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对胆囊癌患者辅助治疗有效性的系统评价。

背景技术关于在胆囊癌（GBC）患者中辅助治疗（AT）的益处存在平衡。这项研究的目的是严格审查有治愈意图的手术对GBC患者AT有效性的有效证据。方法进行了系统的审查。从旅行数据库，BIREME-BVS，SciELO，Cochrane中央登记册，WoS，MEDLINE，EMBASE和SCOPUS中确定了相关研究。考虑的辅助疗法包括化学疗法，放化疗和放疗。主要结果是总体生存期（OS）。对淋巴结阳性（PLND），手术切缘阳性（PSM）或晚期（AS）的患者进行了Subgorup分析。结果确定了748篇相关文章。27个符合选择标准（3个系统评价和24个观察性研究）。提供的证据在化学疗法，放化疗和放疗方面为中度，不良和非常差。现有证据并不充分，但表明AT可以改善OS，尤其是PLND，PSM和AS患者，具有一定的益处。结论结果并未提供强有力的证据证明AT在接受GBC切除的患者中有效。PLND和PSM的亚组可能具有生存优势。需要进一步的研究以适当的内部有效性和足够的患者人数来更好地回答这个问题。PSM和AS。结论结果并未提供强有力的证据证明AT在接受GBC切除的患者中有效。PLND和PSM的亚组可能具有生存优势。需要进一步的研究以适当的内部有效性和足够的患者人数来更好地回答这个问题。PSM和AS。结论结果不能提供强有力的证据证明AT在接受GBC切除的患者中是有效的。PLND和PSM的亚组可能具有生存优势。需要进一步的研究以适当的内部有效性和足够的患者人数来更好地回答这个问题。