Extended Resections for Advanced Gallbladder Cancer: Results from a Nationwide Cohort Study

Kuipers, H.; Lohman, Elise de Savornin; Braat, D.D.M.; Daams, Freek; Erdmann, J.; Hagendoorn, Jeroen; Koerkamp, B. Groot; Reuver, Philip de; Boer, M. de

doi:10.1016/j.hpb.2020.11.886

Cited by 1 publication

(6 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Various patient and tumor related factors are associated with survival in patients with advanced GBC. Preoperative jaundice has been identified as a strong predictor of poor outcomes after resection [7,14,15]. Based on the results of a systematic review, jaundice in GBC is associated with irresectability, post-hepatectomy liver failure, bile leaks, and reduced survival [16].…”

Section: Discussionmentioning

confidence: 99%

“…We defined ER as a major hepatectomy (> 3 liver segments), a PD, or both with or without additional organ resection. In addition, patients requiring arterial or venous resection and reconstruction were also included [7]. The remaining 17 patients underwent wedge resection of the liver bed with portal lymphadenectomy or ≤ 3 segment liver resection.…”

Section: Methodsmentioning

confidence: 99%

“…While surgical resection is the only curative treatment, approximately 10%-20% of patients are amenable to resection at presentation [6,7]. For complete tumor removal of T3-T4 GBC, extended resections (ER) such as a major hepatectomy, pancreaticoduodenectomy (PD), a combined hepatopancreaticoduodenectomy or vascular resection and reconstruction are an option.…”

Section: Introductionmentioning

confidence: 99%

“…For complete tumor removal of T3-T4 GBC, extended resections (ER) such as a major hepatectomy, pancreaticoduodenectomy (PD), a combined hepatopancreaticoduodenectomy or vascular resection and reconstruction are an option. These resections are generally associated with high morbidity (50%), mortality (20%), and uncertain survival benefit, and are only attempted occasionally [7][8][9]. Patient selection remains a challenge and long term survival is possible in a few selected patients.…”

Section: Introductionmentioning

confidence: 99%

“…Without treatment, advanced GBC has an extremely poor prognosis and survival is limited to a few months [10]. There is a lack of data on survival after ER for GBC and results remain conflicting [7]. The need to improve patient selection and the role of ER in advanced GBC remains less well defined.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Survival after extended resections for gallbladder cancer

Bhatti

Dar

Riyaz

et al. 2022

Ann Hepatobiliary Pancreat Surg

View full text Add to dashboard Cite

Backgrounds/Aims: Locally advanced gallbladder cancer (GBC) is associated with survival limited to a few months. Extended resections (ER) are occasionally performed in this group and outcomes remain inconclusive. This study assessed outcomes after ER for locally advanced GBC. Methods: Patients who underwent ER for GBC between 2011 and 2020 were reviewed. ER was defined as a major hepatectomy alone (n = 9), a pancreaticoduodenectomy (PD) with or without minor hepatectomy (n = 3), a major hepatectomy with PD (HPD) (n = 3) or vascular resection and reconstruction (n = 4). We assessed 30-day morbidity, mortality, and 2-year overall survival (OS). Results: Among 19 patients, negative margins were achieved in 14 (73.6%). The 30-day mortality was 1/9 (11.1%) for a major hepatectomy, 0/3 (0%) for a minor HPD, 2/3 (66.7%) for a major HPD, and 1/4 (25.0%) for vascular resection. All short term survivors (< 6 months) (n=8) had preoperative jaundice and 6/8 (75.0%) underwent a major HPD or vascular resection. There were five (26.3%) long term survivors. The median OS in patients with and without preoperative jaundice was 4.1 months (0.7-11.1 months) and 13.7 months (12-30.4 months), respectively (p = 0.009) (2-year OS = 7% vs. 75%; p = 0.008). The median OS in patients who underwent a major hepatectomy alone or a minor HPD was 11.3 months (6.8-17.3 months) versus 1.4 months (0.3-4.1 months) (p = 0.02) in patients who underwent major HPD or vascular resection (2 year OS = 33% vs. not reached) (p = 0.010) respectively. Conclusions: In selected patients with GBC, when ER is limited to a major hepatectomy alone, or a minor HPD, acceptable survival can be achieved.

show abstract