INTRODUCTION: The 5-year survival of patients with gallbladder cancer remains low. However, patients can be stratified into prognostic categories based on established factors such as T, N, and R status. New concepts regarding prognostic significance of lymph node disease, the importance of residual gallbladder fossa disease, and the gravity of presentation with jaundice are reviewed. In addition, a number of new prognostic factors proposed in recent years are considered. METHODS: PubMed was searched for "gallbladder cancer" with builder "date-completion" 2008 to present. A total of 1,490 articles were screened from which 168 were retrieved. From this, 40 articles specifically related to prognosis form the basis for this review. DISCUSSION: Key factors of prognostic significance remain T and N stage and R0 resection. Residual disease either in the gallbladder fossa, lymph nodes, or cystic duct margin dictates hepatectomy, lymphadenectomy and bile duct resection, respectively. Adequate lymphadenectomy requires removal of six nodes, and hepatectomy must be sufficient to achieve R0. Subtleties regarding lymph node ratio, significance of pathological features such as dedifferentiation, and budding may hold value for stratifying patients with early stage disease, but require further investigation.
INTRODUCTION: The 5-year survival of patients with gallbladder cancer remains low. However, patients can be stratified into prognostic categories based on established factors such as T, N, and R status. New concepts regarding prognostic significance of lymph node disease, the importance of residual gallbladder fossa disease, and the gravity of presentation with jaundice are reviewed. In addition, a number of new prognostic factors proposed in recent years are considered. METHODS: PubMed was searched for "gallbladder cancer" with builder "date-completion" 2008 to present. A total of 1,490 articles were screened from which 168 were retrieved. From this, 40 articles specifically related to prognosis form the basis for this review. DISCUSSION: Key factors of prognostic significance remain T and N stage and R0 resection. Residual disease either in the gallbladder fossa, lymph nodes, or cystic duct margin dictates hepatectomy, lymphadenectomy and bile duct resection, respectively. Adequate lymphadenectomy requires removal of six nodes, and hepatectomy must be sufficient to achieve R0. Subtleties regarding lymph node ratio, significance of pathological features such as dedifferentiation, and budding may hold value for stratifying patients with early stage disease, but require further investigation.
Authors: Jean M Butte; Kenichi Matsuo; Mithat Gönen; Michael I D'Angelica; Enrique Waugh; Peter J Allen; Yuman Fong; Ronald P DeMatteo; Leslie Blumgart; Itaru Endo; Hernán De La Fuente; William R Jarnagin Journal: J Am Coll Surg Date: 2010-11-12 Impact factor: 6.113
Authors: Hiromichi Ito; Kaori Ito; Michael D'Angelica; Mithat Gonen; David Klimstra; Peter Allen; Ronald P DeMatteo; Yuman Fong; Leslie H Blumgart; William R Jarnagin Journal: Ann Surg Date: 2011-08 Impact factor: 12.969
Authors: Ajay V Maker; Jean M Butte; Jacqueline Oxenberg; Deborah Kuk; Mithat Gonen; Yuman Fong; Ronald P Dematteo; Michael I D'Angelica; Peter J Allen; William R Jarnagin Journal: Ann Surg Oncol Date: 2011-06-23 Impact factor: 5.344
Authors: Junichi Shindoh; Xabier de Aretxabala; Thomas A Aloia; Juan Carlos Roa; Ivan Roa; Giuseppe Zimmitti; Milind Javle; Claudius Conrad; Dipen M Maru; Taku Aoki; Luca Vigano; Dario Ribero; Norihiro Kokudo; Lorenzo Capussotti; Jean-Nicolas Vauthey Journal: Ann Surg Date: 2015-04 Impact factor: 12.969
Authors: Neda Amini; Yuhree Kim; Ana Wilson; Georgios Antonios Margonis; Cecilia G Ethun; George Poultsides; Thuy Tran; Kamran Idrees; Chelsea A Isom; Ryan C Fields; Bradley Krasnick; Sharon M Weber; Ahmed Salem; Robert C G Martin; Charles Scoggins; Perry Shen; Harveshp D Mogal; Carl Schmidt; Eliza Beal; Ioannis Hatzaras; Rivfka Shenoy; Shishir K Maithel; Timothy M Pawlik Journal: Ann Surg Oncol Date: 2016-05-05 Impact factor: 5.344