BACKGROUND: Although radical re-resection for gallbladder cancer (GBC) has been advocated, the optimal extent of re-resection remains unknown. The current study aimed to assess the impact of common bile duct (CBD) resection on survival among patients undergoing surgery for GBC. METHODS: Patients undergoing curative-intent surgery for GBC were identified using a multi-institutional cohort of patients. Multivariable Cox-proportional hazards regression was performed to identify risk factors for a poor overall survival (OS). RESULTS: Among the 449 patients identified, 26.9% underwent a concomitant CBD resection. The median number of lymph nodes harvested did not differ based on CBD resection (CBD, 4 [IQR: 2-9] vs. no CBD, 3 [IQR: 1-7], P = 0.108). While patients who underwent a CBD resection had a worse OS, after adjusting for potential confounders, CBD resection did not impact OS (HR = 1.40, 95%CI 0.87-2.27, P = 0.170). Rather, the presence of advanced disease (T3: HR = 3.11, 95%CI 1.22-7.96, P = 0.018; T4: HR = 7.24, 95%CI 1.70-30.85, P = 0.007) and the presence of disease at the surgical margin (HR = 2.58, 95%CI 1.26-5.31, P = 0.010) were predictive of a worse OS. CONCLUSIONS: CBD resection did not yield a higher lymph node count and was not associated with an improved survival. Routine CBD excision in the re-resection of GBC is unwarranted and should only be performed selectively. J. Surg. Oncol. 2016;114:176-180.
BACKGROUND: Although radical re-resection for gallbladder cancer (GBC) has been advocated, the optimal extent of re-resection remains unknown. The current study aimed to assess the impact of common bile duct (CBD) resection on survival among patients undergoing surgery for GBC. METHODS:Patients undergoing curative-intent surgery for GBC were identified using a multi-institutional cohort of patients. Multivariable Cox-proportional hazards regression was performed to identify risk factors for a poor overall survival (OS). RESULTS: Among the 449 patients identified, 26.9% underwent a concomitant CBD resection. The median number of lymph nodes harvested did not differ based on CBD resection (CBD, 4 [IQR: 2-9] vs. no CBD, 3 [IQR: 1-7], P = 0.108). While patients who underwent a CBD resection had a worse OS, after adjusting for potential confounders, CBD resection did not impact OS (HR = 1.40, 95%CI 0.87-2.27, P = 0.170). Rather, the presence of advanced disease (T3: HR = 3.11, 95%CI 1.22-7.96, P = 0.018; T4: HR = 7.24, 95%CI 1.70-30.85, P = 0.007) and the presence of disease at the surgical margin (HR = 2.58, 95%CI 1.26-5.31, P = 0.010) were predictive of a worse OS. CONCLUSIONS: CBD resection did not yield a higher lymph node count and was not associated with an improved survival. Routine CBD excision in the re-resection of GBC is unwarranted and should only be performed selectively. J. Surg. Oncol. 2016;114:176-180.
Authors: Tak Geun Oh; Moon Jae Chung; Seungmin Bang; Seung Woo Park; Jae Bok Chung; Si Young Song; Gi Hong Choi; Kyung Sik Kim; Woo Jung Lee; Jeong Youp Park Journal: J Gastrointest Surg Date: 2013-01-09 Impact factor: 3.452
Authors: Xabier de Aretxabala; Ivan Roa; Luis Burgos; Hector Losada; Juan Carlos Roa; Javier Mora; Juan Hepp; Jorge Leon; F Maluenda Journal: J Gastrointest Surg Date: 2006-02 Impact factor: 3.452
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: David Fuks; Jean Marc Regimbeau; Yves-Patrice Le Treut; Philippe Bachellier; Artivas Raventos; François-René Pruvot; Laurence Chiche; Olivier Farges Journal: World J Surg Date: 2011-08 Impact factor: 3.352
Authors: Stefan Buettner; Cecilia G Ethun; George Poultsides; Thuy Tran; Kamran Idrees; Chelsea A Isom; Matthew Weiss; Ryan C Fields; Bradley Krasnick; Sharon M Weber; Ahmed Salem; Robert C G Martin; Charles R Scoggins; Perry Shen; Harveshp D Mogal; Carl Schmidt; Eliza Beal; Ioannis Hatzaras; Rivfka Shenoy; Bas Groot Koerkamp; Shishir K Maithel; Timothy M Pawlik Journal: J Gastrointest Surg Date: 2017-09-14 Impact factor: 3.452
Authors: Kota Sahara; Diamantis I Tsilimigras; Shishir K Maithel; Daniel E Abbott; George A Poultsides; Ioannis Hatzaras; Ryan C Fields; Matthew Weiss; Charles Scoggins; Chelsea A Isom; Kamran Idrees; Perry Shen; Itaru Endo; Timothy M Pawlik Journal: J Surg Oncol Date: 2020-01-06 Impact factor: 2.885