Global epidemiological trends and variations in the burden of gallbladder cancer

Are, Chandrakanth; Ahmad, Humera F.; Ravipati, Advaitaa; Croo, Darren; Clarey, Dillon; Smith, Lynette M.; Price, Ray R.; Butte, Jean M.; Gupta, Sameer; Chaturvedi, Arun; Chowdhury, Shantanu

doi:10.1002/jso.24546

Cited by 66 publications

(58 citation statements)

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“…In addition, the SMAD4 mutation may be a similarly prevalent and convergent predictor of poor OS in patients from all 3 regions. 3,21 Several studies to date have described concurring demographic and clinical features associated with GBCA across different regions in the world. Definitive conclusions must await confirmation in larger series.…”

Section: Discussionmentioning

confidence: 99%

“…In comparison with earlier reports, approximately 93% of mutations detected herein were found to be associated with GBCA previously. 12,[32][33][34][35][36][37][38] Chilean patients had the highest mutation burden, with a median of 7 (range, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20], compared with 6 in the Japanese patients (range, 1-23) and 4 in the American patients (range, 0-27) (P-adj = .006). Mutation burden was not found to be significantly associated with stage of disease (P = .17).…”

Section: The Demographicsmentioning

confidence: 99%

“…Marked differences in global incidence have been noted, with the highest incidence observed in South America . Although the incidence and mortality from GBCA have been rising globally, epidemiologic studies have found that the clinical presentation and pathology of GBCA varies between regions . Of all countries, Chile has the highest GBCA‐specific mortality rate, and GBCA is one of the most common causes of cancer death among Chilean women .…”

Section: Introductionmentioning

confidence: 99%

“…2 Although the incidence and mortality from GBCA have been rising globally, epidemiologic studies have found that the clinical presentation and pathology of GBCA varies between regions. [3][4][5] Of all countries, Chile has the highest GBCA-specific mortality rate, and GBCA is one of the most common causes of cancer death among Chilean women. 6,7 In Japan, the incidence of GBCA is high, but it appears to have a lower associated mortality rate.…”

Section: Introductionmentioning

confidence: 99%

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Regional differences in gallbladder cancer pathogenesis: Insights from a multi‐institutional comparison of tumor mutations

Narayan

Creasy

Goldman

et al. 2018

Cancer

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Background Although rare in the United States, gallbladder cancer (GBCA) is a common cause of cancer death in some parts of the world. To investigate regional differences in pathogenesis and outcomes for GBCA, tumor mutations were analyzed from a sampling of specimens. Methods Primary tumors from patients with GBCA who were treated in Chile, Japan, and the United States between 1999 and 2016 underwent targeted sequencing of known cancer‐associated genes. Fisher exact and Kruskal‐Wallis tests assessed differences in clinicopathologic and genetic factors. Kaplan‐Meier methods evaluated differences in overall survival from the time of surgery between mutations. Results A total of 81 patients were included. Japanese patients (11 patients) were older (median age, 72 years [range, 54‐81 years]) compared with patients from Chile (21 patients; median age, 59 years [range, 32‐73 years]) and the United States (49 patients; median age, 66 years [range, 46‐87 years]) (P = .002) and had more well‐differentiated tumors (46% vs 0% for Chile/United States; P < .001) and fewer gallstone‐associated cancers (36% vs 67% for Chile and 69% for the United States; P = .13). Japanese patients had a median mutation burden of 6 (range, 1‐23) compared with Chile (median mutation burden, 7 [range, 3‐20]) and the United States (median mutation burden, 4 [range, 0‐27]) (P = .006). Tumors from Japanese patients lacked AT‐rich interaction domain 1A (ARID1A) and phosphatidylinositol‐4,5‐bisphosphate 3‐kinase catalytic subunit alpha (PIK3CA) mutations, whereas Chilean tumors lacked Erb‐B2 receptor tyrosine kinase 3 (ERBB3) and AT‐rich interaction domain 2 (ARID2) mutations. SMAD family member 4 (SMAD4) was found to be mutated similarly across centers (38% in Chile, 36% in Japan, and 27% in the United States; P = .68) and was univariately associated with worse overall survival (median, 10 months vs 25 months; P = .039). At least one potentially actionable gene was found to be altered in 80% of tumors. Conclusions Differences in clinicopathologic variables suggest the possibility of distinct GBCA pathogenesis in Japanese patients, which may be supported by differences in mutation pattern. Among all centers, SMAD4 mutations were detected in approximately one‐third of patients and may represent a converging factor associated with worse survival. The majority of patients carried mutations in actionable gene targets, which may inform the design of future trials.

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Section: Discussionmentioning

confidence: 99%

Section: The Demographicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Regional differences in gallbladder cancer pathogenesis: Insights from a multi‐institutional comparison of tumor mutations

Narayan

Creasy

Goldman

et al. 2018

Cancer

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“…Gallbladder cancer (GBC) is the most prevalent biliary tract malignancy and the sixth most common gastrointestinal malignancy worldwide. 1 Due to an asymptomatic course in the early stages, patients are frequently diagnosed in an advanced stage and prognosis is extremely poor. [2][3][4][5] However, long-term survival does occur in patients with early-stage tumors.…”

mentioning

confidence: 99%

Re-resection in Incidental Gallbladder Cancer: Survival and the Incidence of Residual Disease

et al. 2019

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Background. Re-resection for incidental gallbladder cancer (iGBC) is associated with improved survival but little is known about residual disease (RD) and prognostic factors. In this study, survival after re-resection, RD, and prognostic factors are analyzed. Methods. Patients with iGBC were identified from the Netherlands Cancer Registry, and pathology reports of reresected patients were reviewed. Survival and prognostic factors were analyzed. Results. Overall, 463 patients were included; 24% (n = 110) underwent re-resection after a median interval of 66 days. RD was present in 35% of patients and was most frequently found in the lymph nodes (23%). R0 resection was achieved in 93 patients (92%). Median overall survival (OS) of patients without re-resection was 13.7 (95% confidence interval [CI] 11.6-15.6), compared with 52.6 months (95% CI 36.3-68.8) in re-resected patients (p \ 0.001). After re-resection, median OS was superior in patients without RD versus patients with RD (not reached vs. 23.1 months; p \ 0.001). In patients who underwent reresection, RD in the liver (hazard ratio [HR] 5.54; p \ 0.001) and lymph nodes (HR 2.35; p = 0.005) were the only significant prognostic factors in multivariable Electronic supplementary material The online version of this article (

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Systematic review of management of incidental gallbladder cancer after cholecystectomy

Søreide

Guest

Harrison

et al. 2019

Journal of British Surgery

112

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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.

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Global epidemiological trends and variations in the burden of gallbladder cancer

Abstract: Our study demonstrates a rising global burden of GBC with some specific data on geographic and gender-based variations which can be used to develop strategies at the global as well as the high-risk individual country level.

Cited by 66 publications

References 28 publications

Regional differences in gallbladder cancer pathogenesis: Insights from a multi‐institutional comparison of tumor mutations

Regional differences in gallbladder cancer pathogenesis: Insights from a multi‐institutional comparison of tumor mutations

Re-resection in Incidental Gallbladder Cancer: Survival and the Incidence of Residual Disease

Systematic review of management of incidental gallbladder cancer after cholecystectomy

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