Clinicopathological features of long-term survivors after radical resection for gallbladder cancer

Recent reviews of the management of hilar biliary cancer suggest that radical resection is the preferred treatment option. It seems true that most of the long term survivors are treated this way, but it is equally true that most patients receive palliative rather than curative treatment. Before we go too far in our advocacy of radical treatment, we need to develop methods for quantifying palliation because that is in truth what we usually achieve. A method of quantifying palliation is described. Surgeons are encouraged to use methods of this kind in order to allow valid comparison of the results of different methods of treatment.

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Examination of The Characteristics of Long-Term Survivors Among Patients With Gallbladder Cancer With Liver Metastasis Who Underwent Surgical Treatment: A Retrospective Multicenter Study (ACRoS1406)

10.21203/rs.3.rs-1187502/v1 ◽

2022 ◽

Author(s):

Ryota Higuchi ◽

Hiroaki Ono ◽

Ryusei Matsuyama ◽

Yusuke Takemura ◽

Shinjiro Kobayashi ◽

...

Keyword(s):

Overall Survival ◽

Liver Metastasis ◽

Liver Metastases ◽

Gallbladder Cancer ◽

Complete Resection ◽

Hazard Ratio ◽

Negative Margin ◽

Long Term Survivors ◽

Retrospective Multicenter Study

Abstract Background: Gallbladder cancer (GBC) with liver metastasis is considered unresectable. However, there have been infrequent reports of long-term survival in patients with GBC and liver metastases. Therefore, we examined the characteristics of long-term survivors of gallbladder cancer with liver metastasis.Methods: A retrospective multicenter study of 503 patients with GBC (mean age, 68.6 years; female, 52%) was performed. Although patients with pre-operatively diagnosed GBC and liver metastasis were generally excluded from resection, some cases identified during surgery were resected.Result: In patients with resected stage III/IV GBC (n = 228), the period 2007–2013 (vs. 2000–2006, hazard ratio 0.55), other type histology (vs. well/moderate histology, hazard ratio 2.34), ≥2 liver metastases (vs. one liver metastasis, hazard ratio 4.30), and positive margin resection (vs. complete resection with a negative margin, hazard ratio 1.57) were independent prognostic factors for overall survival, whereas one liver metastasis (vs. no liver metastasis) was not. The 5-year overall survival and median survival times in those with one liver metastasis with complete resection and a negative margin (40.9%, 28.3 months) were significantly better than those in patients with ≥2 liver metastases with complete resection and a negative margin (0%, 11.0 months, p = 0.025), and comparable to those in patients with liver metastasis with complete resection and a negative margin (37.0%, 33.0 months). According to the univariate analysis of resected patients with GBC and liver metastases (n=24), minor hepatectomy, less blood loss, less surgery time, papillary adenocarcinoma, T2, morbidity of Clavien–Dindo classification ≤ 2, and adjuvant chemotherapy were significantly associated with longer survival. Long-term survivors (n = 5) had a high frequency of T2 tumors (4/5), had small liver metastases near the gallbladder during or after surgery, underwent minor hepatectomy without post-operative complications, and received post-operative adjuvant chemotherapy.Conclusions: Although there is no surgical indication for GBC with liver metastasis diagnosed pre-operatively, minor hepatectomy and post-operative chemotherapy may be an option for selected patients with T2 GBC and liver metastasis identified during or after surgery who do not have other poor prognostic factors.

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Clinicopathological features of long-term survivors for advanced biliary tract cancer and impact of the number of lymph nodes involved

International Journal of Surgery ◽

10.1016/j.ijsu.2012.12.006 ◽

2013 ◽

Vol 11 (2) ◽

pp. 145-151 ◽

Cited By ~ 7

Author(s):

Shogo Kobayashi ◽

Hiroaki Nagano ◽

Shigeru Marubashi ◽

Koichi Kawamoto ◽

Hiroshi Wada ◽

...

Keyword(s):

Lymph Nodes ◽

Biliary Tract ◽

Biliary Tract Cancer ◽

Clinicopathological Features ◽

Tract Cancer ◽

Long Term Survivors

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Conditional probability of survival in gallbladder carcinoma as a prognostic tool for long term survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.4_suppl.455 ◽

2016 ◽

Vol 34 (4_suppl) ◽

pp. 455-455

Author(s):

Rahul Rajeev ◽

Nicholas Gerard Berger ◽

Abdulrahman Y Hammad ◽

John Thomas Miura ◽

Fabian McCartney Johnston ◽

...

Keyword(s):

Conditional Probability ◽

Gallbladder Carcinoma ◽

Stage Iv ◽

Radical Resection ◽

Prognostic Information ◽

Curative Surgery ◽

Probability Of Survival ◽

Stage Iv Disease ◽

Long Term Survivors

455 Background: Gallbladder carcinoma (GBC) often presents in an advanced stage and despite radical resection and nodal harvest, prognosis remains poor. Conventional survival statistics do not account for time elapsed from diagnosis and may not carry relevant prognostic information for long term survivors. This study sought to estimate the conditional probability of survival (CS) in patients of GBC. Methods: Patients with GBC were identified from the Surveillance, Epidemiology and End Results (SEER) database (1988-2012). Overall probability of survival (OS) was estimated using Kaplan-Meier method. Cumulative incidence method was employed to calculate CS. Results: Of 15,046 GBC patients identified, Stage IV disease was the most common presentation (n = 5625). Surgical intervention was reported in 9,720(65%) patients with cholecystectomies (n = 8254) outnumbering radical resections (n = 1116). 3-year OS for all stages was 18% and conditional probability of surviving additional 3 years (CS3) at 1, 2 and 3 years from diagnosis was 42%, 57% and 66% respectively. Stage III and IV disease had 3-year OS rates of 19% and 3% respectively while CS3 increased progressively with each year survived(33% and 17% at 1 year, 51% and 34% at 2 years, 60% and 56% at 3 years). Conclusions: Conditional probability of survival is favorable in patients surviving one year from diagnosis and shows an increasing trend with time. Improvements in survival are more substantial in patients with adverse initial prognosis. Conditional survival provides valuable information on prognosis to patients after curative surgery and can be the basis of follow-up guidelines.

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P36.11 Clinicopathological Features of Long-Term Survivors in Lung Cancer

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2021.01.1642 ◽

2021 ◽

Vol 16 (3) ◽

pp. S439

Author(s):

S. Talagani ◽

I. Tourkantonis ◽

A. Charpidou ◽

I. Gkiozos ◽

D. Grapsa ◽

...

Keyword(s):

Lung Cancer ◽

Clinicopathological Features ◽

Long Term Survivors

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The clinicopathological features of long-term survivors of metastatic gastric cancer

Annals of Oncology ◽

10.1093/annonc/mdz343.105 ◽

2019 ◽

Vol 30 ◽

pp. vi140

Author(s):

Kenji Ina ◽

Ryuichi Furuta ◽

Megumi Kabeya ◽

Satoshi Hibi ◽

Shu Yuasa ◽

...

Keyword(s):

Gastric Cancer ◽

Metastatic Gastric Cancer ◽

Clinicopathological Features ◽

Long Term Survivors

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Totally Laparoscopic Radical Resection of Gallbladder Cancer: Technical Aspects and Long-Term Results

World Journal of Surgery ◽

10.1007/s00268-018-4490-4 ◽

2018 ◽

Vol 42 (8) ◽

pp. 2592-2598 ◽

Cited By ~ 12

Author(s):

César Muñoz Castro ◽

Sergio Pacheco Santibañez ◽

Tomás Contreras Rivas ◽

Nicolás Jarufe Cassis

Keyword(s):

Gallbladder Cancer ◽

Radical Resection ◽

Long Term Results ◽

Technical Aspects ◽

Totally Laparoscopic

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Propensity Score Analysis of Outcomes Following Laparoscopic or Open Radical Resection for Gallbladder Cancer in T2 and T3 Stages

10.21203/rs.3.rs-900441/v1 ◽

2021 ◽

Author(s):

Changwei Dou ◽

Chunxu Zhang ◽

Jie Liu ◽

Chengwu Zhang

Keyword(s):

Risk Factors ◽

Overall Survival ◽

Propensity Score ◽

Hospital Stay ◽

Gallbladder Cancer ◽

Radical Resection ◽

Perioperative Outcomes ◽

Term Survival ◽

Intraoperative Bleeding

Abstract Background Although laparoscopic radical resection (LLR) has long been contraindicated in gallbladder cancer (GBC), recent studies have demonstrated laparoscopic surgery did not adversely affect the perioperative and survival outcomes of GBC patients. However, these literatures are mainly focused on GBC of relatively early stages or incidental GBC. This study aimed to investigate the perioperative and long-term outcomes of LRR versus open radical resection (ORR) for GBCs in T2 and T3 stages.Methods A retrospective study was conducted on 99 patients with GBC of T2 and T3 stages who underwent radical resection at Zhejiang Provincial People’s Hospital from January 2010 to December 2020. A 1:1 propensity score matching (PSM), which is the best option to overcome selection bias, was conducted to compare the surgical outcomes and long-term prognosis between LRR and ORR. A logistic regression analysis was performed to identify the predictive risk factors of postoperative overall survival.Results By using PSM, the two groups were well balanced with 30 patients in each group. In the LRR group, the length of operation was significantly longer than the ORR group, but the intraoperative bleeding and postoperative days of hospital stay were significantly decreased compared to ORR group. Two groups showed comparable outcomes regarding the incidence of biliary reconstruction, lymph node yield, the incidence of postoperative morbidities, the incidence of Clavien–Dindo (C–D) grade III-IV, the days of drainage tubes indwelling, mortality at 30 postoperative days and 90 postoperative days, and the incidence of port sites metastasis. The 1-, 2-, and 3-year overall survival rates were 61.2, 40.1, and 30.1%, respectively, in the LLR group, and 53.3, 40.1, and 40.1%, respectively, in the OLR group (p=0.644). On multivariate analysis, T stage, vascular invasion and tumor differentiation were found to be the independent risk factors for overall survival of GBC in T2 and T3 stages.Conclusions For GBC in T2 and T3 stages, LRR can achieve comparable perioperative outcomes and long term survival compared to ORR. LRR tend to show advantages over ORR regarding intraoperative bleeding and postoperative days of hospital stay.

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