T2 gallbladder cancer shows substantial survival variation between continents and this is not due to histopathologic criteria or pathologic sampling differences

DeSimone, Mia S.; Goodman, Michael; Pehlivanoğlu, Burçin; Memiş, Bahar; Balcı, Serdar; Roa, Juan Carlos; Jang, Kee Taek; Jang, Jin Young; Hong, Seung Mo; Lee, Kyuho; Kim, Haeryoung; Choi, Hye Jeong; Muraki, Takamura; Araya, J. C.; Bellolio, Enrique; Sarmiento, Juan M.; Maithel, Shishir K.; Losada, Héctor; Baştürk, Olca; Reid, Michelle D.; Koshiol, Jill; Adsay, Volkan

doi:10.1007/s00428-020-02968-5

Cited by 11 publications

(2 citation statements)

References 63 publications

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“…The geographical variations in the incidence of GBC suggest that there are important genetic and environmental factors in the development of the disease. Besides incidence variations, there are also survival variations between countries, as shown for T2 tumours (24). Of the 41 GBC patients, 26 (63.4%) were female.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological prognostic factors for gallbladder carcinoma: a retrospective study

Ramalhosa¹,

Amaral²,

Serôdio³

et al. 2022

J Gastrointest Oncol

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Background: Gallbladder carcinoma (GBC) is an uncommon neoplasm with poor long-term survival. Worldwide the incidence rates vary according to geographic area. The multifactorial aetiology and the rarity of the disease limits the studies to improve outcomes in patients, since the treatment remains mostly surgical. The aim of this study was to identify clinicopathological prognostic factors for survival in patients with GBC submitted to surgery in our institution-a tertiary centre in Portugal. Also, to assess the expression of possible biomarkers (HER2, CD44 and ALDH1) in GBC, as well as the frequency of microsatellite instability (MSI) tumours.Methods: Clinicopathological characteristics of 41 consecutive patients that underwent surgical resection for GBC (2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019) at our hospital were retrospectively reviewed. Clinicopathological factors were assessed and an immunohistochemical (IHC) analysis was done. Microsatellite stability (MSS) was considered if there was maintenance of nuclear expression of MLH1, MSH2, MSH6 and PMS2. Human epidermal growth factor receptor 2 (HER2) expression was evaluated according to the rules applied for gastric cancer and expression of CD44 and ALH1 was evaluated in order to detect cancer stem cells (CSC). Survival analysis was conducted using Kaplan-Meier and Cox regression was used to find prognostic factors.Results: Incidence of GBC in our cohort of patients was 0.45%, most commonly affecting females. Median overall survival (OS) was 23 months with a 39.6% 5-year survival rate. Stage > II [hazard ratios (HR) =8.58; P=0.007], lymphovascular invasion (LVI) (HR =4.06; P=0.045) and hepatic resection (HR =0.288; P=0.034) independently influenced survival. HER2 positivity and high expression of CD44 or ADLH1 did not show significant influence in survival (P=0.649, P=0.868 and P=0.914, respectively), although HER2 and ALDH1 positive patients showed a tendency to a shorter OS, compared to negative patients. We found no relation between these biomarkers expression and disease stage. All analysed samples had MSS.Conclusions: GBC patients with a worse prognosis can be identified. The overexpression of HER2 could select patients for targeted therapy and prompt tissue sampling in unresectable patients.

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Section: Discussionmentioning

confidence: 99%

Clinicopathological prognostic factors for gallbladder carcinoma: a retrospective study

Ramalhosa¹,

Amaral²,

Serôdio³

et al. 2022

J Gastrointest Oncol

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“…Overall, pT2 carcinomas have a 5‐year survival of approximately 45%, although there appear to be geographical differences. Consensus studies have shown that these geographical differences are not related to definitional or histopathological examination differences 97 . Therefore, they are presumably populational or healthcare‐related.…”

Section: Carcinomamentioning

confidence: 99%

Dysplasia and carcinoma of the gallbladder: pathological evaluation, sampling, differential diagnosis and clinical implications

2021

Self Cite

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Pathological evaluation of gallbladder neoplasia remains a challenge. A significant proportion of cases presents as clinically and grossly inapparent lesions, and grossing protocols are not well established. Among epithelial alterations, pseudo‐pyloric gland metaplasia is ubiquitous and of no apparent consequence, whereas goblet cell metaplasia and a foveolar change in surface cells require closer attention. Low‐grade dysplasia is difficult to objectively define and appears to be clinically inconsequential by itself; however, extra sampling is required to exclude the possibility of accompanying more significant lesions. For high‐grade dysplasia (‘high‐grade BilIN’, also known as ‘carcinoma in situ’), a complete sampling is necessary to rule out invasion. Designating in‐situ or minimally invasive carcinomas limited to muscularis or above as early gallbladder carcinoma (EGBC) helps to alleviate the major geographical differences (West/East) in the criteria for ‘invasiveness’ to assign a case to pTis or pT1. Total sampling is crucial in proper diagnosis of such cases. A subset of invasive GBCs (5–10%) arise from the intracholecystic neoplasm (ICN, ‘adenoma‐carcinoma sequence’) category. Approximately two‐thirds of ICNs have invasive carcinoma. However, this propensity differs by subtype. True ‘pyloric gland adenomas’ (> 1 cm) are uncommon and scarcely associated with invasive carcinoma. A distinct subtype of ICN composed of tubular, non‐mucinous MUC6+ glands [intracholecystic tubular non‐mucinous neoplasm (ICTN)] forms a localised pedunculated polyp. Although it is morphologically complex and high‐grade, it appears to be invasion‐resistant. Some of the invasive carcinoma types in the gallbladder have been better characterised recently with adenosquamous, neuroendocrine, poorly cohesive and mucinous carcinomas often being more advanced and aggressive.

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Management of Incidentally Detected Gallbladder Cancer After Cholecystectomy

Søreide

2023

Gallbladder Cancer

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T2 gallbladder cancer shows substantial survival variation between continents and this is not due to histopathologic criteria or pathologic sampling differences

Cited by 11 publications

References 63 publications

Clinicopathological prognostic factors for gallbladder carcinoma: a retrospective study

Clinicopathological prognostic factors for gallbladder carcinoma: a retrospective study

Dysplasia and carcinoma of the gallbladder: pathological evaluation, sampling, differential diagnosis and clinical implications

Management of Incidentally Detected Gallbladder Cancer After Cholecystectomy

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