Eduardo A Vega1, Eduardo Vinuela2, Masayuki Okuno3, Katharina Joechle3, Marcel Sanhueza2, Cristian Diaz2, Nicolas Jarufe4, Jorge Martinez4, Andres Troncoso4, Alfonso Diaz2, Yun S Chun3, Ching-Wei D Tzeng3, Jeffrey E Lee3, Jean-Nicolas Vauthey3, Claudius Conrad5. 1. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Digestive Surgery, Hepato-Bilio-Pancreatic Surgery Unit, Surgery Service, Sotero Del Rio Hospital, Puente Alto, Chile. 2. Department of Digestive Surgery, Hepato-Bilio-Pancreatic Surgery Unit, Surgery Service, Sotero Del Rio Hospital, Puente Alto, Chile; Department of Digestive Surgery, Faculty of Medicine, Catholic University of Chile, Santiago, Chile. 3. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 4. Department of Digestive Surgery, Faculty of Medicine, Catholic University of Chile, Santiago, Chile. 5. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: cconrad1@mdanderson.org.
Abstract
BACKGROUND: Conflicting data exists whether non-oncologic index cholecystectomy (IC) leading to discovery of incidental gallbladder cancer (IGBC) negatively impacts survival. This study aimed to determine whether a subgroup of patients derives a disadvantage from IC. METHODS: Patients with IGBC and non-IGBC treated at an academic USA and Chilean center during 1999-2016 were compared. Patients with T1, T4 tumor or preoperative jaundice were excluded. T2 disease was classified into T2a (peritoneal-side tumor) and T2b (hepatic-side tumor). Disease-specific survival (DSS) and its predictors were analyzed. RESULTS: Of the 196 patients included, 151 (77%) had IGBC. One hundred thirty-six (90%) patients of whom 118 (87%) had IGBC had T2 disease. Three-year DSS rates were similar between IGBC and non-IGBC for all patients. However, for T2b patients, 3-year survival rate was worse for IGBC (31% vs 85%; p = 0.019). In multivariate analysis of T2 patients, predictors of poor DSS were hepatic-side tumor hazard ratio [HR], 2.9; 95% CI, 1.6-5.4; p = 0.001) and N1 status (HR, 2.4; 95% CI, 1.6-3.6; p < 0.001). CONCLUSIONS: Patients with T2b gallbladder cancer specifically benefit from a single operation. These patients should be identified preoperatively and referred to hepatobiliary center. Published by Elsevier Ltd.
BACKGROUND: Conflicting data exists whether non-oncologic index cholecystectomy (IC) leading to discovery of incidental gallbladder cancer (IGBC) negatively impacts survival. This study aimed to determine whether a subgroup of patients derives a disadvantage from IC. METHODS:Patients with IGBC and non-IGBC treated at an academic USA and Chilean center during 1999-2016 were compared. Patients with T1, T4 tumor or preoperative jaundice were excluded. T2 disease was classified into T2a (peritoneal-side tumor) and T2b (hepatic-side tumor). Disease-specific survival (DSS) and its predictors were analyzed. RESULTS: Of the 196 patients included, 151 (77%) had IGBC. One hundred thirty-six (90%) patients of whom 118 (87%) had IGBC had T2 disease. Three-year DSS rates were similar between IGBC and non-IGBC for all patients. However, for T2b patients, 3-year survival rate was worse for IGBC (31% vs 85%; p = 0.019). In multivariate analysis of T2 patients, predictors of poor DSS were hepatic-side tumor hazard ratio [HR], 2.9; 95% CI, 1.6-5.4; p = 0.001) and N1 status (HR, 2.4; 95% CI, 1.6-3.6; p < 0.001). CONCLUSIONS:Patients with T2b gallbladder cancer specifically benefit from a single operation. These patients should be identified preoperatively and referred to hepatobiliary center. Published by Elsevier Ltd.
Authors: Moath Alarabiyat; Syed Soulat Raza; John Isaac; Darius Mirza; Ravi Marudanayagam; Keith Roberts; Manuel Abradelo; David C Bartlett; Bobby V Dasari; Robert P Sutcliffe; Nikolaos A Chatzizacharias Journal: World J Gastroenterol Date: 2022-05-14 Impact factor: 5.374
Authors: Eduardo A Vega; Sebastian Mellado; Omid Salehi; Richard Freeman; Claudius Conrad Journal: Cancers (Basel) Date: 2022-03-10 Impact factor: 6.639