Prognostic heterogeneity of the seventh edition of UICC Stage III gallbladder carcinoma: Which patients benefit from surgical resection?

Sakata, Jun; Kobayashi, Takashi; Ohashi, Takuma; Hirose, Yuki; Takano, Kabuto; Takizawa, Kazuyasu; Miura, Kiyonori; Ishikawa, Hiroyuki; Toge, Koji; Yuza, Kizuki; Soma, Daiki; Ando, Takao; Wakai, Toshifumi

doi:10.1016/j.ejso.2017.01.001

Cited by 11 publications

(9 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Concomitant major hepatectomy, pancreaticoduodenectomy, or even hepatopancreatoduodenectomy with a surprising 5‐year survival rate reaching 30% was previously reported in one Japanese study 27 . Similar significantly improved postsurgical disease‐free survival was also reported by Sakata et al with a promising 10‐year survival rate (51.9%) 28 . Fong et al's study 29 conducted in Western centers also reported surprising 5‐year survival rate reaching 30% among postsurgical T3 and T4 patients.…”

Section: Discussionsupporting

confidence: 62%

The effect of preoperative jaundice in the surgical management of gallbladder carcinoma: An updated meta‐analysis

Regmi

et al. 2021

ANZ Journal of Surgery

View full text Add to dashboard Cite

Background An updated meta‐analysis was performed on the significance of preoperative jaundice in the surgical management of gallbladder carcinoma (GBC). Methods A thorough database searching was performed in PubMed, EMBASE, and the Cochrane library for comparative studies between jaundiced and non‐jaundiced GBC patients. RevMan5.3 and Stata 13.0 software were used for statistical analysis. A total of nine measured outcomes were identified: resectability, R0 resection rate, concurrent bile duct resection, major hepatectomy, vital vascular reconstruction, combined adjacent organ resections, postoperative morbidities, mortalities, and overall survival (OS). Results A total of eight studies were finally included. Newcastle– Ottawa Quality Assessment Scale was used for evaluating the quality of all included studies and the details were recorded in Table S1. Our pooled results revealed that preoperative jaundice was associated with a significantly lower resectability (p < 0.00001), a significantly lower R0 resection rate (p < 0.00001), a significantly higher concurrent bile duct resection rate (p < 0.00001), major hepatectomy rate (≥3 segments) (p < 0.00001), and vital vascular reconstruction rate (portal vein or hepatic artery) (p < 0.00001). Moreover, jaundiced patients experienced more postoperative morbidities (p < 0.00001), mortalities (p < 0.0001), and worse OS (p < 0.00001). However, jaundice was not related to combined adjacent organ resections (p = 0.58). Conclusion Preoperative jaundice in GBC patients seems to be contraindicated to curative resection and the optimal therapeutic strategies should be identified via multidisciplinary team rather than surgery alone. Candidates for curative surgery should be highly selected and experienced centers are preferred. More significant well‐designed studies are required for further exploration.

show abstract

Section: Discussionsupporting

confidence: 62%

The effect of preoperative jaundice in the surgical management of gallbladder carcinoma: An updated meta‐analysis

Regmi

et al. 2021

ANZ Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Japanese surgeons have been aggressive in the management of GBCs and have reported concomitant pancreaticoduodenectomies, hepatectomy, and pancreaticoduodenectomy for advanced GBC with a 5‐year survival of up to 30% . Sakata et al reported significantly improved disease‐specific survival after resection with a 56.4% and 51.9% survival, respectively, at 5 and 10 years. Fong et al from the Western literature also reported a 25% to 30% 5‐year survival with radical resection of T3 and T4 GBC.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of surgical resection of gallbladder cancer in patients presenting with jaundice: A systematic review and meta‐analysis

Dasari

Ionescu

Pawlik

et al. 2018

Journal of Surgical Oncology

View full text Add to dashboard Cite

Introduction Preoperative jaundice is considered a relative contraindication to radical gallbladder cancer (GBC) resection due to poor prognosis and high postoperative morbidity. Recent reports have indicated that aggressive surgery may improve long‐term survival for patients with advanced GBC who present with obstructive jaundice. The current systematic review and meta‐analysis aimed to compare postoperative outcomes among jaundiced and non‐jaundiced patients with resectable GBC. Methods An electronic search was performed using several Medical Subject Headings terms: cholecyst, gallbladder, tumor, cancer, carcinoma, adenocarcinoma, neoplasia, neoplasm, jaundice, and icterus. Overall survival after surgery was the primary outcome; resectability and postoperative morbidity were the secondary outcomes. Results Overall survival was shorter among patients who presented with jaundice (Hazard ratio [HR]: 2.21, 95% confidence interval [CI], 1.64‐2.97; P < 0.001). Patients with jaundice were less likely to have resectable disease (odds ratio: 0.27, 95% CI, 0.17‐0.43; P < 0.001). The jaundice group had higher odds of postoperative morbidity, bile‐leak, and posthepatectomy failure versus the non‐jaundiced control group. Conclusions Radical surgery for GBC resection for patients presenting with obstructive jaundice was associated with reduced overall survival and increased postoperative morbidity. Jaundiced patients with advanced GBC should be considered for surgical resection but need careful evaluation and counseling before undertaking extensive surgical resection.

show abstract

“…LNM has been established as an important prognostic factor for GBCa [7, 9, 26]. However, not all patients with regional LNM have uniformly poor outcomes after resection [27]. Some authors have found that high metastatic lymph node numbers [27, 28] or a high metastatic lymph node ratio [29] was associated with a dismal prognosis in patients with GBCa who had LNM.…”

Section: Discussionmentioning

confidence: 99%

Surgical Indication for Advanced Gallbladder Cancer Considering the Optimal Preoperative Carbohydrate Antigen 19-9 Cutoff Value

et al. 2020

View full text Add to dashboard Cite

Background: Selecting patients who will benefit from resection among those with advanced gallbladder cancer (GBCa) having poor prognostic factors is difficult. Methods: One hundred twenty-one patients who underwent resection for stage II-IV GBCa and 19 unresected patients (unresectable group) were enrolled. The clinical impact of carbohydrate antigen 19-9 (CA19-9) and advanced surgical procedures for GBCa was evaluated. Results: The optimal CA19-9 cutoff value (based on the greatest difference in overall survival) was 250 U/mL. CA19-9 ≥250 U/mL was found to be an independent prognostic factor. Patients with CA19-9 <250 U/mL who developed jaundice (median survival time [MST], 49.1 months) or who required major hepatectomy (MST, 21.5 months) or pancreatoduodenectomy (PD; MST, 50.3 months) had a better prognosis than those with CA19-9 ≥250 U/mL who developed jaundice (MST, 16.1 months; p = 0.061) or who required major hepatectomy (MST, 9.2 months; p = 0.066) or PD (MST, 8.6 months; p = 0.025); their prognosis was comparable to that of the unresectable group (jaundice: p = 0.145, major hepatectomy: p = 0.292, PD: p = 0.756). Conclusions: Even if GBCa patients develop jaundice or require major hepatectomy, or combined PD, resection can be considered for those with CA19-9 <250 U/mL. However, surgical indication should be carefully determined in patients with CA19-9 ≥250 U/mL.

show abstract

Prognostic heterogeneity of the seventh edition of UICC Stage III gallbladder carcinoma: Which patients benefit from surgical resection?

Cited by 11 publications

References 19 publications

The effect of preoperative jaundice in the surgical management of gallbladder carcinoma: An updated meta‐analysis

The effect of preoperative jaundice in the surgical management of gallbladder carcinoma: An updated meta‐analysis

Outcomes of surgical resection of gallbladder cancer in patients presenting with jaundice: A systematic review and meta‐analysis

Surgical Indication for Advanced Gallbladder Cancer Considering the Optimal Preoperative Carbohydrate Antigen 19-9 Cutoff Value

Contact Info

Product

Resources

About