Predictors of curative resection and long term survival of gallbladder cancer – A retrospective analysis

Mishra, Pramod Kumar; Saluja, Sundeep Singh; Sampathrajan, Sowmiya; Varshney, Vaibhav Kumar; Goel, Neha; Patil, Nilesh

doi:10.1016/j.amjsurg.2017.02.006

Cited by 43 publications

(44 citation statements)

References 24 publications

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“…Demographics and disease‐related factors are reported in Table . The average patient age ranged from 50 to 71 years, with the majority of patients being of comparable age in the jaundice and control cohorts; only Mishra et al reported a slightly younger age of patients in the jaundiced group (50 versus 51 years; P = 0.035). Of note, male patients were more likely to present with jaundice than female patients (OR: 1.30, 95% CI, 1.03‐1.64; P = 0.030).…”

Section: Resultsmentioning

confidence: 99%

“…Among the 168 studies that met the initial search criteria, eight studies were selected for the meta‐analysis. Figure illustrates a PRISMA diagram delineating the study selection process.…”

Section: Resultsmentioning

confidence: 99%

“…Among the 168 studies that met the initial search criteria, eight studies [9][10][11][12][13][14][15][16] were selected for the meta-analysis. Figure 1…”

Section: Resultsmentioning

confidence: 99%

“…When the primary outcome of patient survival was not reported as hazard ratios, the method suggested by Parmar et al was used to estimate these ratios from Kaplan‐Meier curves. In cases in which numbers at risk were reported, the curves were evaluated at the corresponding points, and the resulting pairs of values were used in the estimation. For studies without numbers at risk, the curves were evaluated at 6‐month intervals and constant censoring was assumed .…”

Section: Methodsmentioning

confidence: 99%

“…Seven studies [9][10][11][12][13][14]16 consisting of 1960 participants reported overall survival. Overall survival was significantly worse among patients who presented with jaundice, compared with patients who did not (HR: 2.21, 95% CI, 1.64-2.97; P < 0.001).…”

Section: Overall Survival In Resected Patientsmentioning

confidence: 99%

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Outcomes of surgical resection of gallbladder cancer in patients presenting with jaundice: A systematic review and meta‐analysis

Dasari

Ionescu

Pawlik

et al. 2018

Journal of Surgical Oncology

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Introduction Preoperative jaundice is considered a relative contraindication to radical gallbladder cancer (GBC) resection due to poor prognosis and high postoperative morbidity. Recent reports have indicated that aggressive surgery may improve long‐term survival for patients with advanced GBC who present with obstructive jaundice. The current systematic review and meta‐analysis aimed to compare postoperative outcomes among jaundiced and non‐jaundiced patients with resectable GBC. Methods An electronic search was performed using several Medical Subject Headings terms: cholecyst, gallbladder, tumor, cancer, carcinoma, adenocarcinoma, neoplasia, neoplasm, jaundice, and icterus. Overall survival after surgery was the primary outcome; resectability and postoperative morbidity were the secondary outcomes. Results Overall survival was shorter among patients who presented with jaundice (Hazard ratio [HR]: 2.21, 95% confidence interval [CI], 1.64‐2.97; P < 0.001). Patients with jaundice were less likely to have resectable disease (odds ratio: 0.27, 95% CI, 0.17‐0.43; P < 0.001). The jaundice group had higher odds of postoperative morbidity, bile‐leak, and posthepatectomy failure versus the non‐jaundiced control group. Conclusions Radical surgery for GBC resection for patients presenting with obstructive jaundice was associated with reduced overall survival and increased postoperative morbidity. Jaundiced patients with advanced GBC should be considered for surgical resection but need careful evaluation and counseling before undertaking extensive surgical resection.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Among the 168 studies that met the initial search criteria, eight studies [9][10][11][12][13][14][15][16] were selected for the meta-analysis. Figure 1…”

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Overall Survival In Resected Patientsmentioning

confidence: 99%

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Outcomes of surgical resection of gallbladder cancer in patients presenting with jaundice: A systematic review and meta‐analysis

Dasari

Ionescu

Pawlik

et al. 2018

Journal of Surgical Oncology

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Early outcomes of robotic extended cholecystectomy for the treatment of gallbladder cancer

Byun

Choi

Kang

et al. 2020

J Hepato Biliary Pancreat

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BackgroundSimple laparoscopic cholecystectomy is sufficient for patients with early gallbladder cancer (GBC). However, because advanced GBCs of T2 or more advanced stages require more complex procedures such as liver resection and lymph node dissection, minimally invasive surgery (MIS) has not been popularized. To evaluate the applicability of MIS for GBC, we report the early outcomes of robotic extended cholecystectomies (RECs).MethodsThirteen patients who radiologically suspected to have T2 or more advanced stages of GBC underwent REC from February 2018 to April 2019. Thirty‐nine patients who underwent open extended cholecystectomy were selected by 1:3 propensity score matching, and the differences of clinicopathologic features according to surgical methods were analyzed.ResultsCompared with open method, operation time, estimated blood loss, postoperative complication rate, and number of retrieved lymph nodes were not significantly different. In REC group, duration of hospital stay was shorter (6.6 vs 8.3 days, P = .002) and postoperative pain was significantly lower in the REC group (P = .024).ConclusionThe early outcomes of REC were favorable with regard to early recovery and less pain, with similar number of retrieved lymph nodes. REC is a promising option for treatment of GBC, but further long‐term survival studies are needed.

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Towards standardization of management of gallbladder carcinoma with obstructive jaundice: Analysis of 113 cases over 10 years at a single institution

Goel

Gupta

Patkar

et al. 2021

Journal of Surgical Oncology

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Background Presence of jaundice in gallbladder carcinoma (GBC) is considered a sign of inoperability with no defined treatment pathways. Methods Retrospective analysis of all surgically treated GBC patients from January 2010 to December 2019 was performed for evaluating etiology of obstructive jaundice, resectability, postoperative morbidity, mortality, disease‐free survival (DFS) and overall survival (OS). Results Out of 954 patients, 521 patients (54.61%) were locally advanced gallbladder carcinoma (LAGBC: Stage III and IV) and 113 patients (11.84%) had jaundice at presentation. Thirty‐four (30%) patients had benign cause of obstructive jaundice. Median OS of the whole cohort (n=113) was 22 months (16.5–27.49 months) with resectability rate of 62% (70/113). Median OS of curative resection group (n=70) was 32 months and DFS was 25 months. Treatment completion was achieved in 30% (n= 21/70) patients with median OS of 46 months and median DFS of 27 months. Isolated bile duct infiltration subgroup fared the best with median OS of 74 months with a 5‐year survival of 66.7%. Conclusion Surgical resection as a part of multimodality treatment improves survival in carefully selected locally advanced gallbladder cancer patients with jaundice. Early introduction of systemic therapy is the key in the management of this disease with aggressive tumor biology.

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Predictors of curative resection and long term survival of gallbladder cancer – A retrospective analysis

Cited by 43 publications

References 24 publications

Outcomes of surgical resection of gallbladder cancer in patients presenting with jaundice: A systematic review and meta‐analysis

Outcomes of surgical resection of gallbladder cancer in patients presenting with jaundice: A systematic review and meta‐analysis

Early outcomes of robotic extended cholecystectomy for the treatment of gallbladder cancer

Towards standardization of management of gallbladder carcinoma with obstructive jaundice: Analysis of 113 cases over 10 years at a single institution

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