Adjuvant Therapy for Resected Gallbladder Cancer: Analysis of the National Cancer Data Base

Mantripragada, Kalyan; Hamid, Fatima; Shafqat, Hammad; Olszewski, Adam J.

doi:10.1093/jnci/djw202

Cited by 59 publications

(41 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Next, the systemic therapy regimen used in the trial (mitomycin C and 5‐fluorouracil administered on the day of surgery and starting on postoperative week 1, respectively), is not a commonly used approach in the United States. Finally, our findings are consistent with those from previous studies of AC for GBC in Western populations, in which no survival benefit has been consistently observed using this approach . Instead, our results corroborate earlier data supporting the use of AR for GBC.…”

Section: Discussionsupporting

confidence: 92%

“…Finally, our findings are consistent with those from previous studies of AC for GBC in Western populations, in which no survival benefit has been consistently observed using this approach. 13,19 Instead, our results corroborate earlier data supporting the use of AR for GBC. Separate analyses of Surveillance, Epidemiology, and End Results (SEER) and SEER-Medicare data each reported a survival benefit from AR 20 and ACR, 21 especially among patients with lymph nodepositive GBC.…”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

The role of surgery and adjuvant therapy in lymph node–positive cancers of the gallbladder and intrahepatic bile ducts

Cao

Zhang

Sada

et al. 2017

Cancer

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

The role of surgery and adjuvant therapy in lymph node–positive cancers of the gallbladder and intrahepatic bile ducts

Cao

Zhang

Sada

et al. 2017

Cancer

View full text Add to dashboard Cite

show abstract

“…Since 2010, cisplatin and gemcitabine have been the preferred combination, based on results obtained in advanced biliary tract cancer. However, overall application is low (less than 30 per cent) and the overall treatment effect small. Application of adjuvant therapy has remained low in the population at risk, despite data suggesting a survival benefit.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of management of incidental gallbladder cancer after cholecystectomy

Søreide

Guest

Harrison

et al. 2019

Journal of British Surgery

113

View full text Add to dashboard Cite

Background Gallbladder cancer is rare, but cancers detected incidentally after cholecystectomy are increasing. The aim of this study was to review the available data for current best practice for optimal management of incidental gallbladder cancer. Methods A systematic PubMed search of the English literature to May 2018 was conducted. Results The search identified 12 systematic reviews and meta‐analyses, in addition to several consensus reports, multi‐institutional series and national audits. Some 0·25–0·89 per cent of all cholecystectomy specimens had incidental gallbladder cancer on pathological examination. Most patients were staged with pT2 (about half) or pT1 (about one‐third) cancers. Patients with cancers confined to the mucosa (T1a or less) had 5‐year survival rates of up to 100 per cent after cholecystectomy alone. For cancers invading the muscle layer of the gallbladder wall (T1b or above), reresection is recommended. The type, extent and timing of reresection remain controversial. Observation time may be used for new cross‐sectional imaging with CT and MRI. Perforation at initial surgery had a higher risk of disease dissemination. Gallbladder cancers are PET‐avid, and PET may detect residual disease and thus prevent unnecessary surgery. Routine laparoscopic staging before reresection is not warranted for all stages. Risk of peritoneal carcinomatosis increases with each T category. The incidence of port‐site metastases is about 10 per cent. Routine resection of port sites has no effect on survival. Adjuvant chemotherapy is poorly documented and probably underused. Conclusion Management of incidental gallbladder cancer continues to evolve, with more refined suggestions for subgroups at risk and a selective approach to reresection.

show abstract

“…18 Some studies have proven that adjuvant therapy provides a survival bene t in node-positive or ≥ T2 disease according to the NCCN guidelines. [19][20][21][22] some recommended chemotherapy for stage IV GBA patients with gemcitabine and cisplatin. Nevertheless, clinical response rates to these regimens are low, with 10% long term survival and a complete response only in exceptional cases.…”

Section: Discussionmentioning

confidence: 99%

Site-specific Metastases of Gallbladder Adenocarcinoma and Their Prognostic value for Survival: A SEER-based Study

Yang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Gallbladder cancer is a rare but highly malignant cancer, which often progresses to a metastatic stage when diagnosed because of its asymptomatic manifestation. In this study, we intended to analyze the prognostic value of metastatic gallbladder adenocarcinoma (GBA) with site-specific metastases.Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, GBA patients diagnosed with metastases between 2010 and 2016 were selected to identify the prognosis according to the isolated metastatic sites, including liver, lung, bone, brain and distant lymph nodes (DL). Kaplan-Meier methods were used for survival comparisons and multivariable Cox regression models were constructed to find out independent factors that associated with survival.Results: Data from 1526 eligible patients were extracted from the SEER database. Among the patients, 788 (51.6%) had isolated liver metastases, 80 (5.2%) had isolated distant nodal involvement, 45 (2.9%) had isolated lung metastases, 21 (1.4%) had isolated bone metastases, 2 (0.1%) had isolated brain metastases and 590 (38.7%) had multiple metastases. No significant survival difference was shown between patients with single or multisite metastases (P>0.05). Patients with isolated lung or DL metastases had significant better survival outcomes than those with isolated bone metastases (P<0.05). Multivariate analysis showed that performing surgery at primary site, receiving chemotherapy were associated with better OS and CSS for patients with isolated liver or DL metastases.Conclusions: The study showed that different metastatic sites affect survival outcomes in metastatic GBA patients. Highly selected subset of patients with liver or DL metastases might benefit from surgery at primary site.

show abstract

Adjuvant Therapy for Resected Gallbladder Cancer: Analysis of the National Cancer Data Base

Abstract: The curative potential of current adjuvant therapy in gallbladder cancer is questionable, justifying placebo-controlled investigation of novel chemotherapy combinations or alternative approaches. Chemoradiation may provide a short-term benefit in locally advanced tumors.

Cited by 59 publications

References 34 publications

The role of surgery and adjuvant therapy in lymph node–positive cancers of the gallbladder and intrahepatic bile ducts

The role of surgery and adjuvant therapy in lymph node–positive cancers of the gallbladder and intrahepatic bile ducts

Systematic review of management of incidental gallbladder cancer after cholecystectomy

Site-specific Metastases of Gallbladder Adenocarcinoma and Their Prognostic value for Survival: A SEER-based Study

Contact Info

Product

Resources

About