Intramucosal Extent as a Marker for Advanced Disease and Survival in Gallbladder Adenocarcinoma
BACKGROUND: Gallbladder cancer (GBC) is the most common biliary tract malignancy and has a poor prognosis. The clinical significance of focal vs diffuse GBC remains unclear.
METHODS: A retrospective review was conducted on all patients with non-metastatic GBC at a quaternary care center. Pathology was reviewed, and gallbladder cancer pattern was defined based on the extent of mucosal involvement; "diffuse" if the tumor was multicentric or "focal" if the tumor was only in a single location. Patients undergoing liver resection and portal lymphadenectomy were considered to have definitive surgery. The primary outcome was overall survival and assessed by Kaplan-Meier curves.
RESULTS: 63 patients met study criteria with 32 (50.7%) having diffuse cancer. No difference was observed in utilization of definitive surgery between the groups (14 [43.8%] with focal and 12 [38.7%] with diffuse, P = .88). Lymphovascular invasion (P = .04) and higher nodal stage (P = .04) were more common with diffuse GBC. Median overall survival was significantly improved in those with focal cancer (5.1 vs 1.2 years, P = .02). Although not statistically significant, this difference in overall survival persisted in patients who underwent definitive surgery (4.3 vs 2.4 years, P = .70).
DISCUSSION: Patients with diffuse involvement of the gallbladder mucosa likely represent a subset with aggressive biology and worse overall survival compared to focal disease. These findings may aid surgeons in subsequent surgical and medical decision-making for patients with GBC.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
The American surgeon - (2024) vom: 04. Jan., Seite 31348231220581 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Naples, Robert [VerfasserIn] |
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| Links: |
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| Themen: |
Cholecystectomy |
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| Anmerkungen: |
Date Revised 04.01.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1177/00031348231220581 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM366653113 |
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| 500 | |a Citation Status Publisher | ||
| 520 | |a BACKGROUND: Gallbladder cancer (GBC) is the most common biliary tract malignancy and has a poor prognosis. The clinical significance of focal vs diffuse GBC remains unclear | ||
| 520 | |a METHODS: A retrospective review was conducted on all patients with non-metastatic GBC at a quaternary care center. Pathology was reviewed, and gallbladder cancer pattern was defined based on the extent of mucosal involvement; "diffuse" if the tumor was multicentric or "focal" if the tumor was only in a single location. Patients undergoing liver resection and portal lymphadenectomy were considered to have definitive surgery. The primary outcome was overall survival and assessed by Kaplan-Meier curves | ||
| 520 | |a RESULTS: 63 patients met study criteria with 32 (50.7%) having diffuse cancer. No difference was observed in utilization of definitive surgery between the groups (14 [43.8%] with focal and 12 [38.7%] with diffuse, P = .88). Lymphovascular invasion (P = .04) and higher nodal stage (P = .04) were more common with diffuse GBC. Median overall survival was significantly improved in those with focal cancer (5.1 vs 1.2 years, P = .02). Although not statistically significant, this difference in overall survival persisted in patients who underwent definitive surgery (4.3 vs 2.4 years, P = .70) | ||
| 520 | |a DISCUSSION: Patients with diffuse involvement of the gallbladder mucosa likely represent a subset with aggressive biology and worse overall survival compared to focal disease. These findings may aid surgeons in subsequent surgical and medical decision-making for patients with GBC | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a cholecystectomy | |
| 650 | 4 | |a gallbladder cancer | |
| 650 | 4 | |a lymphadenectomy | |
| 650 | 4 | |a pathology | |
| 650 | 4 | |a prognosis | |
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| 700 | 1 | |a Lu, Haiyan |e verfasserin |4 aut | |
| 700 | 1 | |a Allende, Daniela |e verfasserin |4 aut | |
| 700 | 1 | |a Tu, Chao |e verfasserin |4 aut | |
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| 700 | 1 | |a Augustin, Toms |e verfasserin |4 aut | |
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