A CASE OF STAGE IVb GALLBLADDER CANCER WITH A DISEASE-FREE 15-YEAR SURVIVAL AFTER SURGERY

6085 Background: Anemia and tumor hypoxia are known factors for resistance to radio-chemotherapy (RT-CT). In a previous report we have suggested that spinal cord stimulation (SCS) can modify tumor oxygenation and regional blood flow in head and neck cancer (HNC). The aim of the present prospective study was to test the predictive value of pO2 measurement in HNC treated by RT-CT and hypoxia modification using SCS. Methods: Twelve male patients with advanced HNC were analyzed. Stage IVb-IVa: 8–4; mean age 58 + 7.6 years (46–70). Scheduled therapy was hyperfractionated RT (120 cGy/fraction, two fractions/day, total dose 81.6 Gy) from a Co- 60 source, and tegafur 800 mg/day. SCS devices were placed before RT-CT under local anesthesia. During treatment, SCS was connected from 20–30 min before to 20–30 min after each radiotherapy session. Before treatment, they were assessed: Hemoglobin levels and tumor oxygenation pre-SCS and pos-SCS (measured by a polarographic probe system ‘pO2 Histograph‘), expressed as median-pO2, and the fraction of pO2 values less than 5 mmHg (HF5) and less than 2.5 mmHg (HF2.5). Correlations were assessed using Pearson and Spearman tests, and actuarial survival using Kaplan-Meier estimates and Log-rank test. Results: Hemoglobin levels were correlated with oxygenation pre-SCS and pos-SCS: median-pO2 (p=0.005 and p=0.011), HF5 (p=0.048 and p=0.005) respectively. Anemia was associated with more advanced stage (IVb vs IVa, p=0.022), higher HF5 pos-SCS (p=0.028) and lower disease-free survival (p=0.019). The HF2.5 pos-SCS was adversely correlated with the 2 years actuarial: disease-free survival (p=0.027), cause-specific survival (p=0.008) and overall survival (p=0.008). HF2.5 was also correlated with hematocrit (p=0.044). Conclusions: Low hemoglobin levels and anemia are associated with more hypoxic and more advanced tumors. Pre-treatment tumor hypoxia (assessed by the fraction of pO2 values less than 2.5 mmHg during-SCS) is a strong predictive factor for survival in advanced HNC. Patients with highly hypoxic tumors should be selected for more aggressive treatments. Partially supported by: Grant ‘FUNCIS: PI 31–98‘. Scientific supervision was carried out by GICOR. No significant financial relationships to disclose.

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Stage IVB Gallbladder Cancer AJCC v7

10.32388/r4693x ◽

2020 ◽

Author(s):

Keyword(s):

Gallbladder Cancer ◽

Stage Ivb

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Role of adjuvant therapy in resected gallbladder cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.4_suppl.452 ◽

2018 ◽

Vol 36 (4_suppl) ◽

pp. 452-452

Author(s):

Mohamed Abdelrahim Muddathir Hassan ◽

Nicha Wongjarupong ◽

Cristobal T. Sanhueza ◽

Mindy L. Hartgers ◽

Fatima Hassan ◽

...

Keyword(s):

Overall Survival ◽

Adjuvant Therapy ◽

Gallbladder Cancer ◽

Cancer Patients ◽

Surgical Resection ◽

Adjuvant Treatment ◽

Disease Free Survival ◽

Free Survival ◽

Disease Free

452 Background: Surgical resection is the only curative treatment for patients with gallbladder cancer, despite surgical advances many patients ultimately develop recurrent disease. Management of resected gallbladder cancer mostly relies on single-arm trials and retrospective observations. The purpose of our study is to assess the role of adjuvant therapy in stage I-III gallbladder cancer patients who have undergone surgical resection. Methods: Clinical data were collected on 251 patients who underwent surgical resection for stage I-III gallbladder cancer and presented to Mayo clinic from January 2000-December 2015. Patients were then classified into adjuvant treatment group and surveillance only group. Overall survival and recurrence were compared between the two groups. Results: 78 (31.1%) patients received adjuvant therapy while 173 patients were observed only. Patients who received adjuvant tended to be younger (63.0[SD 11] vs 66.2 [SD 13.1]), have higher stage, and underwent extended surgery. Most patients received chemoradiotherapy (55) with 5-Fluorouracil (67.3%) and capecitabine (25.5%) as radiosensitizing agents. 21 patients received additional adjuvant chemotherapy. 27% of patients received chemotherapy as the sole adjuvant treatment. The most common chemo regimens included gemcitabine (52.3%) and gemcitabine plus cisplatin combination (23.8%). On multivariate analysis patients > 65 years(HR 1.53 [1.07-2.19], p = 0.02), males (HR 1.7 [1.2-2.4], p = 0.003), positive margins (2.77 [1.69-4.38], p < 0.01), and stage III (HR 1.91 [1.35-2.70], p < 0.01) had worse overall survival. Patients who underwent extended radical resection (HR 0.73 [0.51-1.05], p = 0.09) had better overall survival. Adjuvant therapy had no statistical significant effect on overall survival (HR 1.10 [0.75-1.59], p = 0.63 or disease free survival (HR 1.05 [0.69-1.59], p = 0.81) on overall population. However, in stage IIIB, patients receiving adjuvant therapy had better overall survival (HR 0.51 [0.25-1.01], p = 0.05) and disease free survival (HR 0.45 [0.19-1.09], p = 0.06). Conclusions: In our study, adjuvant treatment, especially chemoradiation therapy, was only beneficial in patients with stage IIIb gallbladder cancer patients.

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Raised carbohydrate antigen 19-9 levels detect recurrences and impacts overall and disease-free survival in radically resected gallbladder cancer: A simple surveillance marker?

Journal of Cancer Research and Therapeutics ◽

10.4103/jcrt.jcrt_702_20 ◽

2021 ◽

Vol 0 (0) ◽

pp. 0

Author(s):

Sushma Agrawal ◽

Rajan Saxena

Keyword(s):

Gallbladder Cancer ◽

Disease Free Survival ◽

Carbohydrate Antigen ◽

Free Survival ◽

Disease Free

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Disease-free survival for 9 years after liver resection for stage IV gallbladder cancer: Report of a case

Surgery Today ◽

10.1007/bf00311494 ◽

1995 ◽

Vol 25 (8) ◽

pp. 750-753 ◽

Cited By ~ 1

Author(s):

Masayuki Yamamoto ◽

Kazuo Miura ◽

Masakazu Yoshioka ◽

Yoshiro Matsumoto

Keyword(s):

Liver Resection ◽

Gallbladder Cancer ◽

Disease Free Survival ◽

Stage Iv ◽

Free Survival ◽

Disease Free

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Stage IVB Gallbladder Cancer AJCC v8

10.32388/yv6xhr ◽

2020 ◽

Author(s):

Keyword(s):

Gallbladder Cancer ◽

Stage Ivb

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Applicability of sentinel lymph node oriented treatment strategy for gallbladder cancer

PLoS ONE ◽

10.1371/journal.pone.0247079 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0247079

Author(s):

Koya Yasukawa ◽

Akira Shimizu ◽

Hiroaki Motoyama ◽

Koji Kubota ◽

Tsuyoshi Notake ◽

...

Keyword(s):

Lymph Node ◽

Sentinel Lymph Node ◽

Gallbladder Cancer ◽

Disease Free Survival ◽

Free Survival ◽

Node Disease ◽

Local Lymph Node ◽

The Relationship ◽

Disease Free ◽

Better Than

Background Utility of the sentinel lymph node (SLN) biopsy in some malignancies has been reported, however, research on that of gallbladder cancer (GBC) is rare. The aim of this study is to investigate whether the concept of SLN is applicable to T2/3 GBC. Methods A total of 80 patients who underwent resection for gallbladder cancer were enrolled in this study. Patients with GBC were stratified into two groups based on the location of tumor, peritoneal-side (T2p or 3p) and hepatic-side (T2h or 3h) groups. We evaluated the relationship between cystic duct node (CDN) and downstream lymph node (LN) status. CDN was defined as a SLN in this study. Results Thirty-eight patients were classified into T2, including T2p (n = 18) and T2h (n = 20), and 42 patients into T3, including T3p (n = 22) andT3h (n = 20). The incidence of LN metastasis was significantly higher in hepatic-side than peritoneal-side in both T2 and T3 (P = 0.036 and 0.009, respectively). In T2, 14 T2p had negative CDN and downstream LN, however, three T2h had negative CDN and positive downstream LNs (defined as a skipped LN metastasis) (P = 0.043). In T3, patients with skipped LN metastasis were significantly higher in T3h (n = 11) than those in T3p (n = 2) (P<0.001). There was no recurrence of the local lymph node. Disease-free survival in the T2p and T3p were significantly better than those in the T2h and T3h (P = 0.005 and 0.025, respectively). Conclusion The concept of SLN can be applicable to T2p GBC, where the downstream LNs dissection can be omitted.

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A phase I/II study combining radical radiotherapy with concurrent cisplatin in the treatment of advanced squamous cell carcinoma of the cervix

International Journal of Gynecological Cancer ◽

10.1046/j.1525-1438.1992.02040215.x ◽

1992 ◽

Vol 2 (4) ◽

pp. 215-219 ◽

Cited By ~ 2

Author(s):

R. G. Pearcey ◽

G. D. Maclean

Keyword(s):

Squamous Cell Carcinoma ◽

Acute Toxicity ◽

Phase I ◽

External Beam Radiotherapy ◽

External Beam ◽

Advanced Squamous Cell Carcinoma ◽

Radical Radiotherapy ◽

Concurrent Radiotherapy ◽

Stage Ivb ◽

Disease Free

Sixteen patients with advanced cervix cancer have been treated in a phase I/II study of concurrent radiotherapy and cisplatin chemotherapy. The external beam radiotherapy was given as a ‘split course’ because of initial concerns about acute toxicity. The treatment was well tolerated with all patients completing the prescribed radiotherapy and all patients received the intended four doses of cisplatin. One of 5 patients with stage IVB disease is alive and disease free 35 months after treatment. Six of the 11 patients with disease confined to the pelvis are alive and disease free between 28 and 53 months after treatment. One patient has required surgery for a recto-sigmoid stricture.

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Importance of Gross Type in Patients With T2 Gallbladder Cancer

10.21203/rs.3.rs-107876/v1 ◽

2020 ◽

Author(s):

In Sik Shin ◽

Ji Woon Choi ◽

Deok Gie Kim ◽

Sung Whan Cha ◽

Sung Hoon Kim ◽

...

Keyword(s):

Prognostic Factor ◽

Gallbladder Cancer ◽

Medical Records ◽

Disease Free Survival ◽

Tumor Location ◽

Significant Prognostic Factor ◽

Free Survival ◽

Node Metastasis ◽

Disease Free ◽

Exophytic Type

Abstract The 8th edition of the American Joint Committee on Cancer (AJCC) guidelines categorize T2 gallbladder cancer (GBCA) according to pathologic tumor location; peritoneal- and hepatic-side tumors are categorized as T2a and T2b, respectively. We hypothesized that the gross type of GBCA is more important and aimed to investigate their importance in the T2 stage GBCA. Eighty-six patients with GBCA underwent operation from February 2008 to December 2017. We retrospectively reviewed the medical records of 30 patients with pathologically confirmed T2-stage GBCA. There were 8 peritoneal-side and 22 hepatic-side GBCAs. Regarding gross types, 21 and 9 patients had infiltrative- and exophytic-type tumors. Mean disease-free survival (DFS) of T2a and T2b was 38 vs 36 months (p=0.48), respectively, and overall survival (OS) was 50 vs 52 months (p=0.312), respectively. However, patients with infiltrative-type tumors showed significantly worse DFS of 24 months (vs 67 months; p=0.003) and relative different OS of 48 months (vs 67 months; p=0.092). The gross type and lymph node metastasis were the only significant prognostic factor for DFS and OS, respectively. The gross types of T2 gallbladder cancer may be more important prognostic factor than tumor location.

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