Impact of surgical strategies on the survival of gallbladder cancer patients: analysis of 715 cases

Chang, Ying; Li, Qiang; Wu, Qian; Chi, Limin; Bi, Xiaogang; Zeng, Qingmin; Huo, Huaying

doi:10.1186/s12957-020-01915-7

Cited by 18 publications

(36 citation statements)

References 31 publications

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“…Primary gallbladder carcinoma (GBC) was one of the most common and malignant carcinoma of the biliary tract and was the sixth most common cancer of gastrointestinal tract [ 1 ]. Radical resection was the most effective treatment [ 2 ]. However, GBC was asymptomatic and was difficult to diagnose without suspicion in the early stage of occurrence, when the accurate diagnosis was made, radical cure often couldn’t be performed due to direct invasion into adjacent structures such as the hepatic artery or the portal vein [ 3 ], as well as metastasis via the lymphatic, perineural, and hematogenous routes [ 4 ], which resulting in poor overall prognosis [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

The clinical significance of preoperative serum fibrinogen levels and platelet counts in patients with gallbladder carcinoma

et al. 2021

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Background Gallbladder carcinoma (GBC) was the most common malignancy of biliary tract. Patients with malignancies frequently present with activated coagulation pathways, which might potentially related to tumor progression and prognosis. The purpose of the study was to investigate the clinical significance of preoperative serum fibrinogen levels and platelet counts in GBC patients. Methods The preoperative fasting serum fibrinogen levels and platelet counts of 58 patients with GBC were measured by AUV2700 automatic biochemical analyzer, as well as 60 patients with cholesterol polyps and 60 healthy volunteers. Kaplan–Meier survival analysis was applied to show the correction between fibrinogen levels and outcome after surgery. Results The fibrinogen levels of patients with GBC were significantly higher than healthy gallbladder and cholesterol polyp of gallbladder (p < 0.001 and p < 0.001, respectively). In GBC, fibrinogen levels were associated with tumor depth (p = 0.001), lymph node metastasis (p = 0.002), distant metastasis (p < 0.001) and Tumor Node Metastasis (TNM) stage (p < 0.001). The levels in TNM stage IV disease were significantly higher than stage III or stage I + II disease (p = 0.048 and p < 0.001, respectively), and in TNM stage III disease were significantly higher than stage I + II disease (p = 0.002). Furthermore, the overall survival was better in low fibrinogen level group than in high fibrinogen level group (p < 0.001). However, thrombocytosis was not significantly associated with overall survivals (p > 0.05) in multivariate analysis. Conclusions The preoperative serum fibrinogen levels and platelet counts might be reliable biomarkers for the occurance of disease, tumor depth, lymph node metastasis, distant metastasis and advanced TNM stage in patients with GBC. The serum fibrinogen levels might be a prognostic factor to predict outcome for GBC patients suffering from surgery treatment. Anticoagulation therapy might be considered to control cancer progression in future studies.

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Section: Introductionmentioning

confidence: 99%

The clinical significance of preoperative serum fibrinogen levels and platelet counts in patients with gallbladder carcinoma

et al. 2021

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“…Primary gallbladder carcinoma (GBC) was one of the most common and malignant carcinoma of the biliary tract and was the sixth most common cancer of gastrointestinal tract [1]. Radical resection was the most effective treatment [2]. However, GBC was asymptomatic and was di cult to diagnose without suspicion in the early stage of occurrence, when the accurate diagnosis was made, radical cure often couldn't be performed due to direct invasion into adjacent structures such as the hepatic artery or the portal vein [3], as well as metastasis via the lymphatic, perineural, and hematogenous routes [4], which resulting in poor overall prognosis [5].…”

Section: Introductionmentioning

confidence: 99%

The clinical significance of preoperative serum fibrinogen levels and platelet counts in patients with Gallbladder carcinoma

Cao

Jiang

Zhou

et al. 2021

Preprint

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Background: Gallbladder carcinoma (GBC) was the most common malignancy of biliary tract. Patients with malignancies frequently present with activated coagulation pathways, which mightpotentially related to tumor progression and prognosis. The purpose of the study was to investigate the clinical significance of preoperative serum fibrinogen levels and platelet counts in GBC patients.Methods: The preoperative fasting serum fibrinogen levels and platelet counts of 58 patients with GBC were measured by AUV2700 automatic biochemical analyzer, as well as 60 patients with cholesterol polyps and 60 healthy volunteers. Kaplan–Meier survival analysis was applied to show the correction between fibrinogen levels and outcome after surgery.Results: The fibrinogen levels of patients with GBC were significantly higher than healthy gallbladder and cholesterol polyp of gallbladder (p<0.001 and p<0.001,respectively). In GBC, fibrinogen levels were associated with tumor depth (p=0.001), lymph node metastasis (p=0.002), distant metastasis (p<0.001) and Tumor Node Metastasis (TNM) stage (p<0.001).The levels in TNM stage Ⅳ disease were significantly higher than stage Ⅲ or stage Ⅰ+Ⅱ disease（p=0.048 and p<0.001, respectively）, and in TNM stage Ⅲ disease were significantly higher than stageⅠ+Ⅱ disease（p=0.002）.Furthermore, the overall survival was better in low fibrinogen level group than in high fibrinogen level group (p<0.001).However, thrombocytosis was not significantly associated with overall survivals(p>0.05) in univariate analysis.Conclusion: The preoperative serum fibrinogen levels and platelet counts might be reliable biomarkers for the occurance of disease, tumor depth, lymph node metastasis, distant metastasis and advanced TNM stage in patients with GBC. The serum fibrinogen levels might be a prognostic factor to predict outcome for GBC patients suffering from surgery treatment. Anticoagulation therapy might be considered to control cancer progression in future studies.

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“…In our review, lymph node harvest was inadequate in most cases, similar than in the most of the surgical series published in the literature [13,17]. There are no randomised studies addressing the issue of surgery and we have only retrospective analysis and a recently published consensus [5].…”

Section: Lnr Lymph Node Ratiomentioning

confidence: 59%

“…Lymph node involvement (nodal status) is an established prognostic factor in several gastrointestinal tumours [ 13 ]. There are three conventional parameters that describe nodal status: the anatomical location of the involved nodes, the number of involved nodes and the lymph node ratio or LNR.…”

Section: Discussionmentioning

confidence: 99%

“…This recommendation is based on the study published by Ito et al [ 16 ] in which 120 patients with GBC were analysed with a median follow-up of 23 months, of which 41 (34%) had compromised lymph nodes, with an average of three lymph nodes harvested [ 15 ]. The low harvest of lymph nodes is repeated in most of the studies published in literature, with only 5% lymphadenectomy of three or more nodes [ 13 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

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Impact of lymph nodal stage on gallbladder cancer survival after extended cholecystectomy and adjuvant radiochemotherapy: long-term results from an oncology institute, Chile

González-Domingo¹,

Lafuente²,

Luca³

et al. 2021

ecancer

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Introduction: Gallbladder cancer (GBC) is one of the most important causes of cancer death in Chile. Materials and methods:A retrospective review of 103 patients with a diagnosis of GBC who were treated with surgery and adjuvant radiochemotherapy (RT-CT) was carried out at the Oncological Institute of Viña del Mar, Chile. Of these, 56 underwent surgery with oncological criteria, in which the impact of lymph node involvement and prognostic factors for survival were analysed. Results:The median follow-up was 47.5 months. The 5-year survival of the patients operated on with oncological surgery was 55%, and for those resected without oncological criteria, it was 32% (p = 0.02). Regarding the impact of lymph node involvement, 5-year overall survival (OS) in patients with compromised lymph nodes was 32% versus 68% for patients without compromised lymph nodes (p = 0.006). Five-year OS in patients without involved nodes, with 1 involved node or with>1 involved node was 68%, 44% and 12%, respectively (p = 0.0002). The N ratio was grouped in 0, <10% and ≥10%. Five-year OS was 71%, 0% and 24%, respectively (p = 0.003). There was no evidence of differences in survival with respect to the number of lymph nodes studied. Conclusion:Our data provide information regarding the importance of lymph node involvement in patients with GBC undergoing surgery with oncological criteria and adjuvant RT-CT. In the absence of randomised studies, it is suggested to have a more aggressive therapeutic approach in those patients with two or more involved nodes or with a lymph node ratio >10%.

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Impact of surgical strategies on the survival of gallbladder cancer patients: analysis of 715 cases

Cited by 18 publications

References 31 publications

The clinical significance of preoperative serum fibrinogen levels and platelet counts in patients with gallbladder carcinoma

The clinical significance of preoperative serum fibrinogen levels and platelet counts in patients with gallbladder carcinoma

The clinical significance of preoperative serum fibrinogen levels and platelet counts in patients with Gallbladder carcinoma

Impact of lymph nodal stage on gallbladder cancer survival after extended cholecystectomy and adjuvant radiochemotherapy: long-term results from an oncology institute, Chile

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