Effect of different lymph node dissection methods on the number of lymph nodes detected and prognosis in gallbladder cancer

Tang, Xinguo; Zheng, Kangpeng; Huang, Jian; H, Wei; Xu, Lanfang; Xu, Qi; Fan, Yuting; Liu, Jinghang; Li, Bowen; Ran, Lifeng; Liu, Tiande; Liu, Bo; Xiong, Hu; Li, Wen; Fu, Xiaowei; Fj, Lu

doi:10.1097/md.0000000000034163

Cited by 3 publications

(1 citation statement)

References 27 publications

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“…Another study in China of 133 patients found that fusion lymphadenectomy, which uses 3D-SPECT (photon emission CT) and CT or MRI data, may increase the number of both overall retrieved lymph nodes and positive lymph nodes. It improved both the diagnostic accuracy and survival[ 96 ]. A study of 227 GB carcinoma patients assessed the effect of three-dimensional visualization preoperative evaluation and enhanced recovery after surgery and found that precise surgery improved oncological outcomes.…”

Section: Managementmentioning

confidence: 99%

New trends in diagnosis and management of gallbladder carcinoma

Pavlidis,

Galanis,

Pavlidis

2024

World J Gastrointest Oncol

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Gallbladder (GB) carcinoma, although relatively rare, is the most common biliary tree cholangiocarcinoma with aggressiveness and poor prognosis. It is closely associated with cholelithiasis and long-standing large (> 3 cm) gallstones in up to 90% of cases. The other main predisposing factors for GB carcinoma include molecular factors such as mutated genes, GB wall calcification (porcelain) or mainly mucosal microcalcifications, and GB polyps ≥ 1 cm in size. Diagnosis is made by ultrasound, computed tomography (CT), and, more precisely, magnetic resonance imaging (MRI). Preoperative staging is of great importance in decision-making regarding therapeutic management. Preoperative staging is based on MRI findings, the leading technique for liver metastasis imaging, enhanced three-phase CT angiography, or magnetic resonance angiography for major vessel assessment. It is also necessary to use positron emission tomography (PET)-CT or 18F-FDG PET-MRI to more accurately detect metastases and any other occult deposits with active metabolic uptake. Staging laparoscopy may detect dissemination not otherwise found in 20%-28.6% of cases. Multimodality treatment is needed, including surgical resection, targeted therapy by biological agents according to molecular testing gene mapping, chemotherapy, radiation therapy, and immunotherapy. It is of great importance to understand the updated guidelines and current treatment options. The extent of surgical intervention depends on the disease stage, ranging from simple cholecystectomy (T1a) to extended resections and including extended cholecystectomy (T1b), with wide lymph node resection in every case or IV-V segmentectomy (T2), hepatic trisegmentectomy or major hepatectomy accompanied by hepaticojejunostomy Roux-Y, and adjacent organ resection if necessary (T3). Laparoscopic or robotic surgery shows fewer postoperative complications and equivalent oncological outcomes when compared to open surgery, but much attention must be paid to avoiding injuries. In addition to surgery, novel targeted treatment along with immunotherapy and recent improvements in radiotherapy and chemotherapy (neoadjuvant-adjuvant capecitabine, cisplatin, gemcitabine) have yielded promising results even in inoperable cases calling for palliation (T4). Thus, individualized treatment must be applied.

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Section: Managementmentioning

confidence: 99%

New trends in diagnosis and management of gallbladder carcinoma

Pavlidis,

Galanis,

Pavlidis

2024

World J Gastrointest Oncol

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Research progress on prognostic factors of gallbladder carcinoma

Miao,

Liu,

Guo

et al. 2024

J Cancer Res Clin Oncol

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Background Gallbladder carcinoma is the most common malignant tumor of the biliary system, and has a poor overall prognosis. Poor prognosis in patients with gallbladder carcinoma is associated with the aggressive nature of the tumor, subtle clinical symptoms, ineffective adjuvant treatment, and lack of reliable biomarkers. Purpose Therefore, evaluating the prognostic factors of patients with gallbladder carcinoma can help improve diagnostic and treatment methods, allowing for tailored therapies that could benefit patient survival. Methods This article systematically reviews the factors affecting the prognosis of gallbladder carcinoma, with the aim of evaluating prognostic risk in patients. Conclusion A comprehensive and in-depth understanding of prognostic indicators affecting patient survival is helpful for assessing patient survival risk and formulating personalized treatment plans.

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Risk Factors and Prognostic Factors in GBC

Tirca,

Savin,

Stroescu

et al. 2024

JCM

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Background: Gallbladder cancer (GBC) is a rare entity with a poor prognosis, usually discovered late due to nonspecific symptoms; therefore, over the last years, attention has been focused on identifying the risk factors for developing this malignancy in order to provide an early diagnosis, as well as new prognostic factors in order to modulate the long-term evolution of such cases. The aim of this review is to discuss both major risk factors and prognostic factors in GBC for a better understanding and integration of relevant and currently available information. Methods: A literature search was performed using Cochrane Library, PubMed, Google Scholar, Elsevier, and Web of Science; studies published after the year of 2000, in English, were reviewed. Results: Over time, risk factors associated with the development of GBC have been identified, which outline the profile of patients with this disease. The most important prognostic factors in GBC remain TNM staging, safety margin, and R0 status, along with perineural invasion and lymphovascular invasion. Both the technique and experience of the surgeons and a pathological examination that ensures final staging are particularly important and increase the chances of survival of the patients. Conclusions: improvements in surgical techniques and pathological analyses might provide better and more consistent guidance for medical staff in the management of patients with GBC.

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Effect of different lymph node dissection methods on the number of lymph nodes detected and prognosis in gallbladder cancer

Cited by 3 publications

References 27 publications

New trends in diagnosis and management of gallbladder carcinoma

New trends in diagnosis and management of gallbladder carcinoma

Research progress on prognostic factors of gallbladder carcinoma

Risk Factors and Prognostic Factors in GBC

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