Validation of the 8th Edition American Joint Commission on Cancer (AJCC) Gallbladder Cancer Staging System: Prognostic Discrimination and Identification of Key Predictive Factors

Giannis, Dimitrios; Cerullo, Marcelo; Moris, Demetrios; Shah, Kevin N.; Herbert, Garth S.; Zani, Sabino; Blazer, Dan G.; Allen, Peter J.; Lidsky, Michael E.

doi:10.3390/cancers13030547

Cited by 28 publications

(28 citation statements)

References 52 publications

(28 reference statements)

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“…When an accurate diagnosis is made, radical cure often cannot be implemented due to the direct invasion into adjacent structures, such as the hepatic artery or portal vein, as well as metastasis via the lymphatic, perineural, and hematogenous routes ( 4 – 6 ). The median overall survival (OS) for GBC was about 6 months, with a 5-year survival rate of 5% ( 7 , 8 ). Therefore, it is important to improve the early diagnostic rate of patients with GBC and evaluate their prognosis perioperative-operation.…”

Section: Introductionmentioning

confidence: 99%

A Novel Clinically Prognostic Stratification Based on Prognostic Nutritional Index Status and Histological Grade in Patients With Gallbladder Cancer After Radical Surgery

Cao

Hong

et al. 2022

Front. Nutr.

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PurposeGallbladder carcinoma (GBC) is the most common malignancy of the biliary tract, with a 5-year survival rate of 5%. The prognostic models to predict the prognosis of patients with GBC remain controversial. Therefore, to construct a prognosis prediction of GBC, a retrospective cohort study was carried out to investigate the prognostic nutritional index and histological grade in the long-term outcome of patients with GBC after radical surgery (RS).MethodsA retrospective study of a total of 198 patients with GBC who underwent surgical treatment were enrolled. The hematological indicators, imageological data, and perioperative clinical data were acquired for statistical analysis and poor prognosis model construction.ResultsPrognostic nutrition index (PNI) < 45.88, maximum tumor diameter (MTD) > 2.24 cm, and jaundice (JD) were all associated with a poor prognosis in multivariate logistic regression analysis. The prognosis prediction model was based on the three risk factors, which indicated a superior predictive ability in the primary cohort [area under the curve (AUC) = 0.951] and validation cohort (AUC = 0.888). In multivariate Cox regression analysis, poorly differentiation (PD) was associated with poor 3-year survival. In addition, Kaplan–Meier (KM) survival analysis suggested that GBC patients with high-risk scores and PD had a better prognosis after RS (p < 0.05), but there was no significant difference in prognosis for patients with non-poorly differentiation (NPD) or low-risk scores after RS (p > 0.05).ConclusionOur prediction model for GBC patients with prognosis evaluation is accurate and effective. For patients with PD and high-risk scores, RS is highly recommended; a simple cholecystectomy can also be considered for acceptance for patients with NPD or low-risk score. The significant findings provide a new therapeutic strategy for the clinical treatment of GBC.

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Section: Introductionmentioning

confidence: 99%

A Novel Clinically Prognostic Stratification Based on Prognostic Nutritional Index Status and Histological Grade in Patients With Gallbladder Cancer After Radical Surgery

Cao

Hong

et al. 2022

Front. Nutr.

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“…Several parameters related to lymph node dissection have been investigated, including the optimal number of harvested nodes, the positive lymph node number, and the positive lymph node ratio, while current data on their prognostic value vary between studies 59,61,62. The most current guidelines by AJCC recommend dissection and evaluation of at least 6 lymph nodes to accurately stage GBC 53,63. Resection of the common bile duct should not be done routinely to increase the number of harvested lymph nodes and is indicated only if the tumor extends into the bile duct or intraoperative frozen section reveals marginal cystic duct involvement.…”

Section: Discussionmentioning

confidence: 99%

Trends in Primary Gallbladder Cancer Incidence and Incidence-based Mortality in the United States, 1973 to 2015

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Giannis

Thuong

et al. 2022

American Journal of Clinical Oncology

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Objectives: Primary gallbladder cancer (GBC) is the most common biliary tract cancer with poor survival despite aggressive treatment. This study aimed to investigate the trends of GBC incidence and incidencebased mortality (IBM) over the last 4 decades.Materials and Methods: GBC cases diagnosed between 1973 and 2015 were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Incidence rates, IBM rates, and annual percent changes (APCs) were calculated and stratified according to population and tumor characteristics. Results:The cohort consisted of 10,792 predominantly white (81%) and female (71%) GBC patients. The overall GBC incidence decreased by 1.65% (95% confidence interval [CI]: 1.45% to 1.84%) per year since 1973, but has plateaued since 2002. IBM decreased by 1.69% (95% CI: 1.22% to 2.16%) per year from 1980 to 2015; the rate of decrease in IBM rates was lower during 1997 to 2015 (APC: −1.19%, 95% CI: −1.68% to −0.71%) compared with 1980 to 1997 (APC: −3.13%, 95% CI: −3.68% to −2.58%). Conclusions:The incidence and IBM rates of GBC have been decreasing over the last 40 years, but the decrease plateaued over the last 2 decades. The effects of treatment modalities, including laparoscopic cholecystectomy, adjuvant chemotherapy, and radiation on the incidence and IBM of GBC need to be further investigated.

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“…The only curative approach for GBC is surgery. It requires a simple cholecystectomy in the early stages or a major hepatectomy and lymphadenectomy in more advanced stages [ 7 ]. However, more than 50% of cases are unresectable at the time of diagnosis, and indeed, GBC is burdened by poor prognosis with an estimated 5-year survival of 5% to 13% due to late presentation, early infiltration of surrounding tissues, and lack of successful treatments [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Palliation in Gallbladder Cancer: The Role of Gastrointestinal Endoscopy

Schepis

Boškoski

Tringali

et al. 2022

Cancers

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Gallbladder cancer is a rare malignancy burdened by poor prognosis with an estimated 5-year survival of 5% to 13% due to late presentation, early infiltration of surrounding tissues, and lack of successful treatments. The only curative approach is surgery; however, more than 50% of cases are unresectable at the time of diagnosis. Endoscopy represents, together with surgery and chemotherapy, an available palliative option in advanced gallbladder cancers not eligible for curative treatments. Cholangitis, jaundice, gastric outlet obstruction, and pain are common complications of advanced gallbladder cancer that may need endoscopic management in order to improve the overall survival and the patients’ quality of life. Endoscopic biliary drainage is frequently performed to manage cholangitis and jaundice. ERCP is generally the preferred technique allowing the placement of a plastic stent or a self-expandable metal stent depending on the singular clinical case. EUS-guided biliary drainage is an available alternative for patients not amenable to ERCP drainage (e.g., altered anatomy). Gastric outlet obstruction is another rare complication of gallbladder malignancy growing in contact with the duodenal wall and causing its compression. Endoscopy is a less invasive alternative to surgery, offering different options such as an intraluminal self-expandable metal stent or EUS-guided gastroenteroanastomosis. Abdominal pain associated with cancer progression is generally managed with medical treatments; however, for incoercible pain, EUS-guided celiac plexus neurolysis has been described as an effective and safe treatment. Locoregional treatments, such as radiofrequency ablation (RFA), photodynamic therapy (PDT), and intraluminal brachytherapy (IBT), have been described in the control of disease progression; however, their role in daily clinical practice has not been established yet. The aim of this study is to perform a review of the literature in order to assess the role of endoscopy and the available techniques in the palliative therapy of advanced gallbladder malignancy.

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Validation of the 8th Edition American Joint Commission on Cancer (AJCC) Gallbladder Cancer Staging System: Prognostic Discrimination and Identification of Key Predictive Factors

Cited by 28 publications

References 52 publications

A Novel Clinically Prognostic Stratification Based on Prognostic Nutritional Index Status and Histological Grade in Patients With Gallbladder Cancer After Radical Surgery

A Novel Clinically Prognostic Stratification Based on Prognostic Nutritional Index Status and Histological Grade in Patients With Gallbladder Cancer After Radical Surgery

Trends in Primary Gallbladder Cancer Incidence and Incidence-based Mortality in the United States, 1973 to 2015

Palliation in Gallbladder Cancer: The Role of Gastrointestinal Endoscopy

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