BACKGROUND: Gallbladder cancer (GBC) carries an unfavorable prognosis with high mortality. This retrospective study was conducted to identify prognostic factors after resection of GBC, to assist in selecting appropriate surgical and adjuvant therapy. METHODS: Sixty-two patients from two institutions were identified with GBC by pathology. In 25, the cancer was unresectable at presentation. The remaining 37 patients comprised the study population. Log-rank analysis was used to assess univariate association with disease-free survival (DFS) and disease-specific survival (DSS). Cox regression was used for multivariate analysis. RESULTS: Median DFS and DSS were 22.6 and 28.5 months respectively, with a median follow-up of 44.2 months. On univariate analysis, bile duct (BD) involvement was significantly associated with decreased DFS (P ≤ .001) and DSS (P = .004). BD involvement was uniformly fatal. LN involvement was not significantly associated with DFS or DSS (P = .85, P = .54). CONCLUSIONS: All patients with BD involvement in our population died of the disease. The subset of patients with resectable GBC and BD involvement is a group that is at high risk for recurrence and should be treated as such. In our small population, preoperative and intraoperative methods evaluating BD involvement were unreliable.
BACKGROUND: Gallbladder cancer (GBC) carries an unfavorable prognosis with high mortality. This retrospective study was conducted to identify prognostic factors after resection of GBC, to assist in selecting appropriate surgical and adjuvant therapy. METHODS: Sixty-two patients from two institutions were identified with GBC by pathology. In 25, the cancer was unresectable at presentation. The remaining 37 patients comprised the study population. Log-rank analysis was used to assess univariate association with disease-free survival (DFS) and disease-specific survival (DSS). Cox regression was used for multivariate analysis. RESULTS: Median DFS and DSS were 22.6 and 28.5 months respectively, with a median follow-up of 44.2 months. On univariate analysis, bile duct (BD) involvement was significantly associated with decreased DFS (P ≤ .001) and DSS (P = .004). BD involvement was uniformly fatal. LN involvement was not significantly associated with DFS or DSS (P = .85, P = .54). CONCLUSIONS: All patients with BD involvement in our population died of the disease. The subset of patients with resectable GBC and BD involvement is a group that is at high risk for recurrence and should be treated as such. In our small population, preoperative and intraoperative methods evaluating BD involvement were unreliable.
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: Samuel J Wang; Andrew Lemieux; Jayashree Kalpathy-Cramer; Celine B Ord; Gary V Walker; C David Fuller; Jong-Sung Kim; Charles R Thomas Journal: J Clin Oncol Date: 2011-11-07 Impact factor: 44.544
Authors: A Duffy; M Capanu; G K Abou-Alfa; D Huitzil; W Jarnagin; Y Fong; M D'Angelica; R P Dematteo; L H Blumgart; E M O'Reilly Journal: J Surg Oncol Date: 2008-12-01 Impact factor: 3.454
Authors: Jason M Foster; Hisakazu Hoshi; John F Gibbs; Renuka Iyer; Miland Javle; Quyen Chu; Boris Kuvshinoff Journal: Ann Surg Oncol Date: 2006-11-11 Impact factor: 5.344
Authors: Michael D'Angelica; Kimberly Moore Dalal; Ronald P DeMatteo; Yuman Fong; Leslie H Blumgart; William R Jarnagin Journal: Ann Surg Oncol Date: 2008-11-05 Impact factor: 5.344
Authors: Ahmedin Jemal; Rebecca Siegel; Elizabeth Ward; Taylor Murray; Jiaquan Xu; Carol Smigal; Michael J Thun Journal: CA Cancer J Clin Date: 2006 Mar-Apr Impact factor: 508.702
Authors: Samuel J Wang; C David Fuller; Jong-Sung Kim; Dean F Sittig; Charles R Thomas; Peter M Ravdin Journal: J Clin Oncol Date: 2008-03-31 Impact factor: 44.544