Improvement of survival in VA patients with gall bladder cancer given chemotherapy

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4132-4132 ◽  
Author(s):  
M. Atiq ◽  
M. M. Safa ◽  
R. S. Komrokji ◽  
A. R. Jazieh ◽  
A. F. Muhleman ◽  
...  

4132 Background: Gallbladder carcinoma, though rare, has very poor prognosis. Most of patients with gall bladder carcinoma present with either unresectable disease or metastasis. Median survival in gall bladder carcinoma has been documented to be 6 months in SEER data. There is no data available on the outcome of Veterans’ Affair (VA) patients with gall bladder carcinoma. Impact of chemotherapy in adjuvant and metastatic setting is not well-studied. Methods: We used the VA Central Cancer Registry (VACCR) to analyze VA patients with Gall Bladder cancer diagnosed between 1995 and 2005. The reference date for data collection and reporting is January 1, 1995. This site aggregates the data collected by the medical centers’ cancer registries. Data was entered and analyzed using bio-statistical software SPSS. Results: There were a total of 232 patients. Of these, 185 (79.7%) were whites and 37 (15.9%) were blacks. The mean age was 71 years. Pathology was adenocarcinoma in 198 (85.3%), non-specified carcinoma in 29 (12.5%) and small cell carcinoma in 5 (2.2%) cases. Overall median survival was 5.27 months. Surgery was performed in 119 patients (51%). Only 19 (16%) patients received adjuvant chemotherapy. The baseline characteristics were similar between patients who received adjuvant chemotherapy and no adjuvant chemotherapy. Also, the median survival was similar (8.3 months vs. 8.7 months) (P-value 0.37). In patients who did not undergo surgery, the median survival for patients who received chemotherapy was 8.0 months vs 1.7 months for patients who did not receive chemotherapy (p-value 0.013). Eighty-nine (38.5%) patients were diagnosed with stage IV disease. Amongst these patients chemotherapy improved the median survival (2 months vs. 6.97 months; p-value 0.04). In a Cox regression model stage, surgical margins, surgery, chemotherapy were independent predictors of patient survival. Conclusions: Gall bladder carcinoma in VA patients has similar survival compared to other reports. Our data is one of the largest retrospective cohorts in gall bladder cancer and suggests that chemotherapy improves survival in advanced gall bladder cancer patients. No significant financial relationships to disclose.

Author(s):  
Pratibha Pandey ◽  
Uzma Sayyed ◽  
Rohit Tiwari ◽  
Neelam Pathak ◽  
Mohammad Haris Siddiqui ◽  
...  

Curcumin, the primary bioactive component isolated from turmeric, has been shown to possess variety of biologic functions including anti-cancer activity. However, meticulous mechanism of the curcumin in gall bladder cancer has not been explored yet. Therefore, in our study, we elucidated the mechanism of the anticancer action of curcumin against human gall bladder cancer cells. It was found that the curcumin treated GBC cells decreased cell viability in a dose and time-dependent manner. Nuclear condensation, Annexin V-FITC/PI positive cells, and caspase-3 activation confirmed the apoptotic induction due to anti-proliferative action of curcumin. Furthermore, curcumin induced disruption in the mitochondrial membrane potential and increased reactive oxygen species generation which has not yet been reported in earlier studies of curcumin with gall bladder cancer. Moreover, curcumin-induced apoptosis of gall bladder cancer cells was also accompanied by significant amount of growth arrest at the G0/G1 phase of the cell cycle which has also not been documented previously. To the best part of my knowledge, this study has established curcumin as one of the promising chemotherapeutic agent against gall bladder carcinoma. Thus the present study explored a novel mechanism explaining the anti cancerous effects of curcumin, and may provide an alternative therapeutic approach which can overcome the side effects of chemotherapy. Keywords: Gall bladder carcinoma Curcumin; Cell cycle analysis; Caspase-3; Apoptosis


Author(s):  
Madhusmita Choudhury ◽  
Gargi Roy Choudhury ◽  
Monoj K. Deka ◽  
Shah A. Sheikh

Background/Objective: Gall bladder carcinoma (GBC) is an aggressive malignancy with high mortality and aggressive course, with palliation as the only available option. The signs and symptoms of gall bladder arcinoma are not specific and often present late. Diagnosis is, therefore, often made at advanced stage with poorer outcomes. Identifying biomarkers and cancer specific cellular targets, that will pave the way for novel therapeutic approaches and early diagnosis for gall bladder carcinoma, is urgently needed. Proto-oncogenes (HER-2) and E-Cadherin are commonly deregulated in gallbladder cancer (GBC). This study evaluates the prognostic significance of HER-2 and E-Cadherin in GBC patients in Silchar Medical College.Our main objective was to evaluate frequency of HER-2/neu overexpression in GBC and to seek its correlation, if any with conventional clinicopathological parameters and survival.Methods: A total of 168 cases were received and evaluated for Gall Bladder cancer and control specimens were prospectively collected from 2018-2020. Immunohistochemical staining was done using monoclonal antibodies to semiquantitatively evaluate HER-2 and E-Cadherin protein expression. The criterion for HER-2 and E-Cadherin positivity was set at 10% and >5% tumor cells showing complete, membranous staining. Clinicopathological correlations were drawn with major clinical outcomes. Results: It was observed that out of 168 cases the male to female ratio is 1:5 with highest number of cases in the age group of 50-59 , i.e., 70 cases with 41.7%. The most common location in this study was fundus with 69% of cases (116 out 0f 168), most commonly presented as biliary colic with 56 number of cases. Grading was also done in 168 cases where most number of cases were moderately differentiated with 86 number of cases with a percentage of 51%. Expression of Her2Neu and E-Cadherin was evaluated where highest number of cases were seen with 1+ score  in the IHC expressions of both the markers with 81 and 61 number of cases respectively. Conclusion: The increasing global incidence, late presentation leading to poor prognosis and lack of effective therapy make the management of gall bladderv carcinoma really challenging. Our study shows the abnormal expression of HER-2 and E-Cadherin expression in gall bladder carcinoma patients in Southern Assam and suggests that  these two markers can be used for potential tool for early detection of gall bladder carcinoma and also can be used for targeted therapy in gall bladder carcinoma.


2019 ◽  
Vol 12 (12) ◽  
pp. e232715
Author(s):  
Venkata Vishwanath Reddych ◽  
Ashok Kumar ◽  
Manas Aggarwal ◽  
Kailash Chand Kurdia

An isolated dilatation of the cystic duct (type VI choledochal cyst (CDC)) is extremely rare with only 21 cases reported in the world literature until now. There is only one case of in situ gall bladder cancer (GBC) reported in association with type VI CDC in the literature. Here we are reporting a case of type VI CDC with papillary GBC.


Author(s):  
I. Vijaya Bharathi ◽  
P. Urmila Devi ◽  
A. Bhagya Lakshmi

Background: Gall bladder is among the most common surgically resected organs with various neoplastic and non-neoplastic lesions. Chronic chocystitis is the most commonly encountered lesion in India and worldwide and 78-90% are associated with calculi. Gall bladder cancer constitutes 0.5% to 1.09% including both suspected and incidental diagnosis. The objective of present study was to evaluate the various lesions of Gall bladder and the importance of grossing and histopathological examination of every cholecystectomy specimen in order to diagnose the incidental gall bladder cancer (IGBC).Methods: A Retrospective study of cholecystectomy specimens for a period of one year, May 2015 to June 2016 was carried out. 252 Cholecystectomy specimens were received and all of them subjected for histopathological examination and the sections stained with routine Hematoxylin and Eosin stain.Results: Commonest age group being 21-40years (41%) followed by 41-60years (40%). Gall bladder (GB) lesions are more common in females 175 (70%) and M:F ratio 1:2.2.Most commonest lesions were Chronic calculous cholecystitis constituting 155 cases (61%) followed by chronic cholecystitis 52 cases (21%). Cholelithiasis was associated with both Acute and Chronic Cholecytitis constituting 67%. Acute calculous cholecystits constitute 13 cases (5%) and Acute cholecystitis constitutes 10 cases (4%). In Congenital anomalies, 3 cases (1.2%) of Biliary atresia and 4 cases (1.2%) of choledochal cyst were diagnosed. 4 cases (1.6%) of Gall bladder carcinoma was diagnosed. Among these 3 cases were incidental gall bladder carcinoma (IGBC).Conclusions: cholecystectomy specimens should be subjected for histopathological examination to study various lesions of GB and to detect unsuspected incidental gall bladder cancer as cholecystectomy itself is the treatment for gall bladder cancer and also other lesions of GB associated with cholelithiasis.


2019 ◽  
Vol 23 (11) ◽  
pp. 2232-2238
Author(s):  
Abhay K. Kattepur ◽  
Shraddha Patkar ◽  
Mahesh Goel ◽  
Anant Ramaswamy ◽  
Vikas Ostwal

2021 ◽  
Vol 18 (4) ◽  
pp. 724-728
Author(s):  
Dhiresh Kumar Maharjan ◽  
Prabin Bikram Thapa

Background: Laparoscopic approach for early gall bladder cancer (T1b and T2) has been seen to have equal or better early outcomes and late outcomes in terms of overall survival rate and recurrence rate.Methods: This is a prospective cross sectional observational study performed including all consecutive patients who were diagnosed with gall bladder cancer by a single surgical team from August 2018 to February 2020 at Kathmandu Medical College Teaching Hospital or referred from outside for completion extended cholecystectomy where laparoscopic cholecystectomy was done in some other centre.Results: The mean age of the patients was 51.01±9.42 years in the laparoscopic extended cholecystectomy (N=10) group and 49.6±8.35 years in the open extended cholecystectomy (N=10) group (p value=0.711). Conversion rate was 20% in laparoscopic group. The operative time was longer in the laparoscopic group (287 +/-66.50 minutes, 120.0 to 446 minutes vs. 200+/-66.50 minutes, 100 to 405.0 minutes; p< 0.004.However, the laparoscopic extended cholecystectomy group showed faster time to oral intake and time to first passage of flatus and had shorter hospital stay by 2.2 days (4.8+/-0.78 days) than open approach 7+/-0.81 days.(p value=0.00).There were no significant differences between the groups in the tumour size (p=0.079) and number of harvested lymph nodes 9.3 (5 to 13) in laparoscopic group vs. 11.2 (8 to 15) in open extended cholecystectomy group (p=0.250).Conclusions: Laparoscopic extended cholecystectomy is feasible in early gall bladder cancer along with achievement of oncological safety.Keywords: Gall bladder cancer; laparoscopic extended cholecystectomy; open extended cholecystectomy


2022 ◽  
Vol 2022 ◽  
pp. 1-6
Author(s):  
Weiwei Zhao ◽  
Yanxuan Gong ◽  
Yugang Chen

Background. Gall Bladder Cancer (GBC) is a type of extremely malignant tumor, which has high incidences of mortality. There is rare information about its mechanisms of invasion and gene expression regulations. microRNA-155 (miR-155) has mostly been reported to be over expressed in cases of solid tumors and hematopoietic malignancies. In this study, we have investigated the role and clinical significance of miR-155 in a Chinese population suffering from GBC and compared the results with nonneoplastic inflammation. Methods. Tissue specimens were collected on 50 patients of Gall Bladder Carcinoma and 10 patients suffering from nonneoplastic inflammation who have undergone surgeries at the Department of Pathology, Renji Hospital, Shanghai, from January 2019 to January 2020. We performed profiling of miR-155 expression in both nonneoplastic and gall bladder carcinoma tissues by QRT-PCR. Results. Expression levels of miR-155 were found to be extremely high in GBC patients in comparison to the nonneoplastic tissues ( ∗ P < 0.05 ), as high miRNA is correlated with TNM stages. Further results noted were that miR-145-5p expressed genes mimic the gene expression of STAT1, a downregulation of IRF7 was noted in the GBC, and an activation of STAT1 was significantly noted in carcinoma cells of the gallbladder. Downregulation of PTPRF was also noted during the expression of miR-145. Conclusions. As downregulation of IRF7 is linked with low rates of survival, it was found that gall bladder carcinoma patients may face high mortality. The STAT-1 expression of unregulated in GBC patients was also noted.


2020 ◽  
Vol 19 (16) ◽  
pp. 2019-2033 ◽  
Author(s):  
Pratibha Pandey ◽  
Mohammad H. Siddiqui ◽  
Anu Behari ◽  
Vinay K. Kapoor ◽  
Kumudesh Mishra ◽  
...  

Background: The aberrant alteration in Jab1 signalosome (COP9 Signalosome Complex Subunit 5) has been proven to be associated with the progression of several carcinomas. However the specific role and mechanism of action of Jab1 signalosome in carcinogenesis of gall bladder cancer (GBC) are poorly understood. Objective: The main objective of our study was to elucidate the role and mechanism of Jab1 signalosome in gall bladder cancer by employing siRNA. Methods: Jab1 overexpression was identified in gall bladder cancer tissue sample. The role of Jab1-siRNA approach in cell growth inhibition and apoptotic induction was then examined by RT-PCR, Western Blotting, MTT, ROS, Hoechst and FITC/Annexin-V staining. Results: In the current study, we have shown that overexpression of Jab1 stimulated the proliferation of GBC cells; whereas downregulation of Jab1 by using Jab1-siRNA approach resulted incell growth inhibition and apoptotic induction. Furthermore, we found that downregulation of Jab1 induces cell cycle arrest at G1 phase and upregulated the expression of p27, p53 and Bax gene. Moreover, Jab1-siRNA induces apoptosis by enhancing ROS generation and caspase-3 activation. In addition, combined treatment with Jab1-siRNA and gemicitabine demonstrated an enhanced decline in cell proliferation which further suggested increased efficacy of gemcitabine at a very lower dose (5μM) in combination with Jab1-siRNA. Conclusion: In conclusion, our study strongly suggests that targeting Jab1 signalosome could be a promising therapeutic target for the treatment of gall bladder cancer.


2019 ◽  
Vol 19 (6) ◽  
pp. 826-837 ◽  
Author(s):  
Pratibha Pandey ◽  
Preeti Bajpai ◽  
Mohammad H. Siddiqui ◽  
Uzma Sayyed ◽  
Rohit Tiwari ◽  
...  

Background:Plant sterols have proven a potent anti-proliferative and apoptosis inducing agent against several carcinomas including breast and prostate cancers. Jab1 has been reported to be involved in the progression of numerous carcinomas. However, antiproliferative effects of sterols against Jab1 in gall bladder cancer have not been explored yet.Objective:In the current study, we elucidated the mechanism of action of stigmasterol regarding apoptosis induction mediated via downregulation of Jab1 protein in human gall bladder cancer cells.Methods:In our study, we performed MTT and Trypan blue assay to assess the effect of stigmasterol on cell proliferation. In addition, RT-PCR and western blotting were performed to identify the effect of stigmasterol on Jab1 and p27 expression in human gall bladder cancer cells. We further performed cell cycle, Caspase-3, Hoechst and FITC-Annexin V analysis, to confirm the apoptosis induction in stigmasterol treated human gall bladder cancer cells.Results:Our results clearly indicated that stigmasterol has up-regulated the p27 expression and down-regulated Jab1 gene. These modulations of genes might occur via mitochondrial apoptosis signaling pathway. Caspase-3 gets activated with the apoptotic induction. Increase in apoptotic cells and DNA were confirmed through annexin V staining, Hoechst staining, and cell cycle analysis.Conclusion:Thus, these results strongly suggest that stigmasterol has the potential to be considered as an anticancerous therapeutic agent against Jab1 in gall bladder cancer.


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