Cholecystectomy is associated with higher risk of early recurrence and poorer survival after curative resection for early stage hepatocellular carcinoma

Abstract

Although cholecystectomy has been reported to be associated with increased risk of developing hepatocellular carcinoma (HCC), the association between cholecystectomy and prognosis of HCC patients underwent curative resection has never been examined. Through retrospective analysis of the data of 3933 patients underwent curative resection for HCC, we found that cholecystectomy was an independent prognostic factor for recurrence-free survival (RFS) of patients at early stage (BCLC stage 0/A) (p = 0.020, HR: 1.29, 95% CI: 1.04–1.59), and the 1-, 3-, 5-year RFS rates for patients at early stage were significantly worse in cholecystectomy group than in non-cholecystectomy group (80.5%, 61.8%, 52.0% vs 88.2%, 68.8%, 56.8%, p = 0.033). The early recurrence rate of cholecystectomy group was significantly higher than that of non-cholecystectomy group for patients at early stage (59/47 vs 236/333, p = 0.007), but not for patients at advanced stage (BCLC stage C) (p = 0.194). Multivariate analyses showed that cholecystectomy was an independent risk factor for early recurrence (p = 0.005, HR: 1.52, 95% CI: 1.13–2.03) of early stage HCC, but not for late recurrence (p = 0.959). In conclusion, cholecystectomy is an independent predictor for early recurrence and is associated with poorer RFS of early stage HCC. Removal of normal gallbladder during HCC resection may be avoided for early stage patients.

Concurrent Cholecystectomy Is Associated with a Lower Risk of Recurrence after Curative Resection in Early-Stage Hepatocellular Carcinoma: A 10 Year Observational Single-Center Study

“…A recent cohort study by Li et al demonstrated that concurrent cholecystectomy increased the risk of recurrence and negatively affected survival after surgical resection in early-stage HCC [14]. In contrast, our study indicates that cholecystectomy may reduce the risk of tumor recurrence after curative resection in patients with HCC.…”

“…Although a previous study reported cholecystectomy was associated with a higher risk of early recurrence and poorer survival after curative resection for early-stage HCC [14], there were still many issues unresolved. The most important was that the surgical indication of concurrent cholecystectomy in HCC patients is not widely advocated.…”

Postoperative adjuvant transarterial chemoembolization for multinodular hepatocellular carcinoma within the Barcelona Clinic Liver Cancer early stage and microvascular invasion

“…The BCLC stage recommended curative treatment methods for the HCC patients with single nodule or ≤3 nodules with none >3 cm, Child-Pugh classification A-B, Eastern Cooperative Oncology Group (ECOG) =0, and without gross vascular invasion and extrahepatic metastasis, which was defined as the early stage (4). The 5-year survival rate of these patients can reach 70-80% after hepatectomy (5)(6)(7).…”

Gallbladder dysfunction caused by MYPT1 ablation triggers cholestasis-induced hepatic fibrosis in mice

“…[3] Whether gallbladder pathologies induce hepatic disorders remains unclear. Notably, various complications can occur after cholecystectomy (ie, the symptoms of dyspepsia, bile reflux, biliary injury, and increased risks of liver fibrosis, HCC, and gastrointestinal cancer [4][5][6][7] ), implying involvement of the gallbladder in liver disorders under certain conditions.…”