scholarly journals Is combined extra-hepatic bile-duct resection justified for advanced gallbladder carcinoma?

2019 ◽  
Vol 7 (6) ◽  
pp. 426-433 ◽  
Author(s):  
Jun-Ke Wang ◽  
Wen-Jie Ma ◽  
Zhen-Ru Wu ◽  
Qin Yang ◽  
Hai-Jie Hu ◽  
...  
Keyword(s):  
Lymph Node ◽  
Bile Duct ◽  
Lymph Node Metastasis ◽  
Gallbladder Carcinoma ◽  
Curative Surgery ◽  
Hepatic Bile ◽  
Hepatic Bile Duct ◽  
Resection Group ◽  
Node Metastasis ◽  
T Category

Abstract Background Whether the extra-hepatic bile duct (EHBD) should be routinely resected for gallbladder carcinoma (GBC) remains controversial. The current study aimed to determine the clinical impact of combined EHBD resection during curative surgery for advanced GBC. Methods In total, 213 patients who underwent curative surgery for T2, T3 or T4 GBC were enrolled. The clinicopathological features were compared between the patients treated with EHBD resection and those without EHBD resection. Meanwhile, univariable and multivariable Cox-proportional hazards regression models were used to identify risk factors for overall survival (OS). Results Among the 213 patients identified, 87 (40.8%) underwent combined EHBD resection. Compared with patients without EHBD resection, patients with EHBD resection suffered more post-operative complications (33.3% vs. 21.4%, P = 0.046). However, the median OS of the EHBD resection group was longer than that of the non-EHBD resection group (25 vs. 11 months, P = 0.008). Subgroup analyses were also performed according to tumor (T) category and lymph-node metastasis. The median OS was significantly longer in the EHBD resection group than in the non-EHBD resection group for patients with T3 lesion (15 vs. 7 months, P = 0.002), T4 lesion (11 vs. 6 months, P = 0.021) or lymph-node metastasis (12 vs. 7 months, P < 0.001). No survival benefit of EHBD resection was observed in GBC patients with T2 lesion or without lymph-node metastasis. T category, lymph-node metastasis, margin status, pre-operative CA19-9 level and EHBD resection were identified as independent prognostic factors for OS of patients with advanced GBC (all P values <0.05). Conclusions EHBD resection can independently affect the OS in advanced GBC. For GBC patients with T3 lesion, T4 lesion and lymph-node metastasis, combined EHBD resection is justified and may improve OS.

scholarly journals Impacts Of Tumor Location On Prognosis Of Patients With Gallbladder Carcinoma

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.

scholarly journals Evaluation of extra capsular lymph node involvement in patients with extra-hepatic bile duct cancer

2012 ◽  
Vol 10 (1) ◽  
Author(s):  
Takehiro Noji ◽  
Masaki Miyamoto ◽  
Kanako C Kubota ◽  
Toshiya Shinohara ◽  
Yoshiyasu Ambo ◽  
...  
Keyword(s):  
Lymph Node ◽  
Bile Duct ◽  
Bile Duct Cancer ◽  
Lymph Node Involvement ◽  
Hepatic Bile ◽  
Hepatic Bile Duct ◽  
Node Involvement ◽  
Duct Cancer

High-dose remote afterloading intraluminal brachytherapy in the treatment of unresectable hilar or upper bile duct carcinoma.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 273-273
Author(s):  
H. Andoh ◽  
Y. Shindo
Keyword(s):  
Lymph Node ◽  
Bile Duct ◽  
Lymph Node Metastasis ◽  
Median Survival ◽  
Bile Duct Carcinoma ◽  
Survival Rates ◽  
High Dose ◽  
Duct Carcinoma ◽  
Node Metastasis ◽  
Group I

273 Background: To evaluate intraluminal brachytherapy (ILBT) for the treatment of unresectable hilar or upper bile duct carcinoma. Methods: Between 1992 and 2005, 48 patients were identified who were not indicated for surgical resections. Among them, 22 patients received only biliary drainage (group I) and 26 patients received ILBT (group II). Expandable metallic stents (EMSs) were used in 17 patients and ILBT was delivered using the Varisource 200 remote afterloading unit with a 10 Ci 192Ir or 60Co. Each treatment of ILBT delivered 6 Gy at a 1-cm depth, and was repeated weekly for 5 weeks. A total of 30 Gy was administered to each patient. Survival rates between the groups were compared using Kaplan-Meier survival curves. Results: In group I, survival rates at 6 and 12 months were 9% and 0%, respectively. Median survival was only 2 months. In contrast, group II survival rates at 6, 12, and 24 months were 77%, 54%, and 9%, respectively, and the median survival of this group was 13 months. Improved survival with the use of ILBT was significant, particularly in clinical stages III, IVa (p<0.01), and IVb (p<0.05). ILBT helped keep the bile duct lumen patent for a long period, but was not effective for the treatment of patients with positive lymph node metastasis. Conclusions: Although randomized controlled studies will be necessary, the results of the present study are encouraging for using high-dose ILBT in the treatment of unresectable hilar or upper bile duct carcinoma without lymph node metastasis. No significant financial relationships to disclose.

scholarly journals The Correlation between miRNA and Lymph Node Metastasis in Gastric Cancer

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Kuo-Hung Huang ◽  
Yuan-Tzu Lan ◽  
Wen-Liang Fang ◽  
Jen-Hao Chen ◽  
Su-Shun Lo ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cancer Patients ◽  
Lymphovascular Invasion ◽  
Tnm Stage ◽  
Stromal Reaction ◽  
Node Metastasis ◽  
Gastric Cancer Patients ◽  
T Category

Lymph node metastasis (LNM) in gastric cancer is associated with higher rate of cancer recurrence and poor prognosis. As a result, a reliable biomarker for the prediction of LNM is important and would be valuable in the clinical practice. MiRNA microarray revealed that ten miRNAs were expressed significantly different among patients with or without LNM. A total of 46 gastric cancer patients were enrolled and divided into two groups (23 in each group) according to the presence or absence of LNM. RT-PCR of these 10 miRNAs was investigated and compared between the two groups. MiR-1207-5p was significantly upregulated in gastric cancer patients without LNM compared with those with LNM. Patients with upregulated miR-1207-5p had less scirrhous stromal reaction, less lymphovascular invasion, and earlier pathological T category, N category, and TNM stage, compared with those with downregulated or unchanged miR-1207-5p. Multivariate analysis showed that stromal reaction type, lymphovascular invasion, pathological T category and TNM stage, and expression of miR-1207-5p were independent risk factors of LNM. MiR-1207-5p could serve as a useful biomarker in the prediction of LNM in gastric cancer.

scholarly journals The Clinical and Prognostic Factors for Biliary Neuroendocrine Neoplasm: A Study Based on the SEER Database

2021 ◽  
Author(s):  
Bohao Zheng ◽  
Cheng Zhang ◽  
Wenze Wan ◽  
Wentao Sun ◽  
Xi Cheng ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Bile Duct ◽  
Lymph Node Metastasis ◽  
Neuroendocrine Neoplasm ◽  
Biliary Duct ◽  
Seer Database ◽  
Postoperative Prognosis ◽  
Node Metastasis

Abstract Background: In this study, we aimed at elucidating the postoperative survival and prognostic factors in patients with biliary neuroendocrine neoplasm (NEN).Methods: Cases of biliary system NEN and adenocarcinoma were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. A propensity score matching (PSM) method was used to adjust baseline differences in clinicopathological characteristics in our analysis. The Kaplan-Meier analysis was carried out for survival analysis. Results：A total of 243 patients with biliary system NEN were enrolled in this study, of which 119 patients’ lesions located in gallbladder, while the others’ located in bile duct. The postoperative overall survival of bile duct NEN is significantly longer than that of gallbladder NEN (P<0.001). For GB-NENs, surgery method (P=0.020) and lymph node metastasis (P=0.018) were identified as independent prognostic factors. In terms of AOV NENs, age (P=0.017) and lymph node metastasis (P=0.006) were identified was independent prognostic factor, while grade (P=0.002) and lymph node metastasis (P=0.036) were identified as independent prognostic factors for EBD NENs. PSM analysis indicated that patients with biliary duct NENs have better postoperative prognosis than biliary duct adenocarcinoma.Conclusions: Patients with NEN have better overall survival than patients with adenocarcinoma. Gallbladder NEN has adverse prognosis than that of biliary tract NEN. Pathological subtype, differentiation, lymph node metastasis, surgery method and lymph node resection could affect postoperative prognosis of gallbladder and biliary tract NEN.

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