Tumor Characteristics and Survival Analysis of Incidental Versus Suspected Gallbladder Carcinoma

Context.—Advanced gallbladder carcinoma (GBC) is a highly fatal disease with poor prognosis and few therapeutic alternatives. The mammalian target of rapamycin (mTOR) is a serine/threonine kinase that plays a central role in cell growth and homeostasis. Its regulation is frequently altered in various tumors and is an attractive target for cancer therapy; however, its status in GBC remains unclear. Objective.—To characterize immunohistochemical expression and prognostic significance of phospho-mTOR in advanced gallbladder carcinoma. Design.—Phospho-mTOR expression was examined by immunohistochemistry in tissue microarrays containing 128 advanced GBCs and 99 cases of chronic cholecystitis, which were divided into 2 groups according to the presence or absence of metaplasia. To evaluate the association of the level of phospho-mTOR expression with clinical variables and patient survival, the advanced GBCs were classified as having low or high expression. Statistical analysis was performed by using a significance level of P < .05, and Kaplan-Meier curves were constructed for survival analysis. Results.—Immunostaining for phospho-mTOR was positive in 82 of 128 tumors (64.1%) and in 24% of chronic cholecystitis cases (16% nonmetaplasia and 32% with metaplasia) (P < .001). Survival analysis indicated that a high phospho-mTOR immunohistochemical expression was associated with poorer prognosis in patients with advanced GBC (P = .02). Conclusions.—Metaplasia is a common finding in chronic cholecystitis and is considered a precursor lesion of dysplasia. Our results suggest that the activation of mTOR occurs very early during the development of GBC, contributing to the carcinogenesis process. Phospho-mTOR expression is correlated with poor survival, supporting the potential of mTOR for targeted therapy.

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Survival analysis following resection of AJCC stage III gallbladder carcinoma based on different combinations of T and N stages

Korean Journal of Hepato-Biliary-Pancreatic Surgery ◽

10.14701/kjhbps.2015.19.1.11 ◽

2015 ◽

Vol 19 (1) ◽

pp. 11 ◽

Cited By ~ 3

Author(s):

Kyoung-Yeon Hwang ◽

Young-In Yoon ◽

Shin Hwang ◽

Tae-Yong Ha ◽

Chul-Soo Ahn ◽

...

Keyword(s):

Survival Analysis ◽

Gallbladder Carcinoma ◽

Stage Iii ◽

Ajcc Stage

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Impacts Of Tumor Location On Prognosis Of Patients With Gallbladder Carcinoma

10.21203/rs.3.rs-41650/v1 ◽

2020 ◽

Author(s):

Zhencheng Zhu ◽

Kunlun Luo ◽

Qingzhou Zhu ◽

Weixuan Xie

Keyword(s):

Survival Analysis ◽

Lymph Node ◽

Bile Duct ◽

Liver Metastasis ◽

Lymph Node Metastasis ◽

Gallbladder Carcinoma ◽

Tumor Location ◽

Node Metastasis ◽

Significant Difference ◽

Bile Duct Invasion

Abstract Objective: To investigate the impacts of tumor location on the prognosis of patients with T1-3N0-1M0 gallbladder carcinoma(GBC) after radical surgery.Methods: Totally, 136 patients with stage T1-3 gallbladder carcinoma after radical surgery from 2000 to 2018 were enrolled and divided into two groups according to anatomic location of GBC (neck /body and fundus). The clinicopathological features and survival time were compared between these two groups. At last, in combination with the difference between the liver side and the peritoneal side of the tumor, survival analysis and multivariable Cox-proportional hazards regression models were performed in GBC patients with survival differences between gallbladder neck and body/fundus tumors.Results: The bile duct invasion, lymph node metastasis, tumor growth pattern, jaundice, albumin, and tumor markers were significantly related to the tumors in neck of gallbladder(P<0.05). Besides, patients with GBC in body and fundus of gallbladder had a higher rate of appearing microscopic liver metastasis(P<0.05). Survival analysis showed that there was significant difference on patients with stage T2 GBC in different tumor location (neck /body and fundus), but no significant difference on stage T1 and T3. Further combining the differences between the liver side and the peritoneal side of the tumor, tumor location, lymph node metastasis, bile duct invasion, microscopic liver metastasis, tumor differentiation, and jaundice were deemed as prognostic factors according to univariable survival analysis. Among these factors, multivariable Cox analysis showed that lymph node metastasis and tumor location were independent prognostic factors for survival of patients with T2 GBC (P <0.05).Conclusions: Tumor location is an important prognostic factor for GBC, especially for the patients with T2 stage. Besides the survival differences between the hepatic-side and peritoneal-side tumors, tumor in neck is also one of the factors predicting the poor prognosis at T2 stage. GBC in neck was more prone to cause bile duct invasion, lymph node metastasis and jaundice. However, tumors in body and fundus were more likely to appear microscopic liver metastasis. Further refinement of the surgery for T2 GBC according to the tumor location may improve their survival time.

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Outcomes and utilization of adjuvant chemotherapy (AT) for stage II colon cancer (CC-II) in elderly population.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.4_suppl.701 ◽

2019 ◽

Vol 37 (4_suppl) ◽

pp. 701-701 ◽

Cited By ~ 1

Author(s):

Afsaneh Barzi ◽

Xiayu Jiao ◽

Joel W Hay ◽

Sarmad Sadeghi

Keyword(s):

Colon Cancer ◽

Overall Survival ◽

Survival Analysis ◽

Clinical Characteristics ◽

Health Maintenance Organization ◽

Tnm Staging ◽

Stage Ii ◽

P Value ◽

Tumor Characteristics ◽

Health Maintenance

701 Background: The use of AT in elderly patients (pts) with CC-II is controversial. We used Surveillance Epidemiology End Results (SEER) linkage with Medicare claims to explore the patterns of AT and survival in pts with CC-II diagnosed between 2004-2010. Methods: Colon cancer was identified using ICD-O-3 codes. TNM staging information was used to classify pts as stage II and its subgroups. We restricted our cohort to pts who had surgery within 4 months (mos) of the diagnosis using ICD-9 codes: 45.7x and 45.8x and excluded pts who died within 3 mos after the surgery as well as those who were enrolled on a health maintenance organization. We searched Medpar, outpatient facility, or carrier claims in the 4 mos after surgery to identify pts who received AT using ICD-9 diagnosis and procedure codes, HCPCS, and revenue center codes. Logistic regression was used to assess the relationship between demographics and clinical characteristics of pts in each group and receipt of AT. Kaplan-Meier method was used for survival analysis. We performed a flexible parametric survival analysis to estimate the 3-year overall survival benefit for AT while controlling for demographics and clinical characteristics. Results: A total of 15,310 pts were included in our study. Among those, 14% (n=2,168ss received AT of which 718 (33%) received oxaliplatin containing regimen. Pts and tumor characteristics are reported in the table. After adjusting for pts and tumor characteristics, probability of survival at 3 years was 72.9% for pts who received AT and 74.2% for those who did not, HR=1.06 (95% CI, 0.96-1.17), with P-value: 0.229. The AT use was declining over time. Conclusions: Although AT is used in healthier and higher risk elderly pts with colon cancer, it was not associated with significantly improved overall survival. [Table: see text]

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