Managing the incidentally detected gallbladder cancer: Algorithms and controversies

Cavallaro, Andrea; Piccolo, Gaetano; Vita, Maria Di; Zanghì, Antonio; Cardì, F; Mattia, Paolo Di; Barbera, Giuseppina; Borzì, Laura; Panebianco, Vincenzo; Carlo, Isidoro Di; Cavallaro, Marco; Cappellani, Alessandro

doi:10.1016/j.ijsu.2014.08.367

Cited by 59 publications

(80 citation statements)

References 52 publications

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“…Similarly, in the included researches, Kim et al and Cavallaro et al respectively compared the 1-and 3-year survival rate after two kinds of surgery, which was all up to 100%. 14,16 Also, few patients suffered from post-operative tumor recurrence in these studies. Lee et al carried out a systematic review for T1 stage GBC, in included researches of which 67% and 30% patients with T1b GBC respectively accepted simple cholecystectomy and radical resection.…”

Section: Sensitivity Analysis and Bias Identifymentioning

confidence: 79%

“…Heterogeneity exists (χ2 = 11.54, P = 0.17, I2 = 31%), hence random model was used, and the result shows RR is obviously better than SC in increasing 1-year survival rate (OR=3.28, 95% CI: 1.83-5.89, P<0.0001). In addition, in the study of Kim et al, Cavallaro et al and Ke et al 14,16,19 1-year survival rate of stage II GBC were all 100%. Ten studies recorded 3-year survival rate.…”

Section: Survival Rate Analysismentioning

confidence: 90%

“…5,[11][12][13][14][15][16][17][18][19][20][21][22][23][24] All the studies were non-randomized control trials. Table 1 and 2 respectively show the character of included literatures and NOS quality assessment scale.…”

Section: Characteristics Of Included Literatures and Quality Assessmentmentioning

confidence: 99%

“…5,[11][12][13][14][16][17][18][19]21,23,24 Data of 1-year survival rate from nine studies can be pooled (Figure 2). Heterogeneity exists (χ2 = 11.54, P = 0.17, I2 = 31%), hence random model was used, and the result shows RR is obviously better than SC in increasing 1-year survival rate (OR=3.28, 95% CI: 1.83-5.89, P<0.0001).…”

Section: Survival Rate Analysismentioning

confidence: 99%

“…Ten studies recorded 3-year survival rate. 5,11,13,[16][17][18][19][20][21]24 Figure 3 presents the pooled data of 3-year survival rate, the result shows there's no heterogeneity (χ2 = 6.46, P = 0.60, I2 = 0%), fix model was used and it's obviously that RR contributes to higher survival rate for stage II GBC patients (OR = 2.52, 95% CI: 1.49-4.28, P=0.0006). Besides, 3-year survival rate of stage II GBC was 100% in the study of Cavallaro et al 16 Figure 5: Analysis of the recurrence rate after simple cholecystectomy and radical resection.…”

Section: Survival Rate Analysismentioning

confidence: 99%

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Simple cholecystectomy versus radical resection for stage Ⅱ gallbladder cancer: a meta-analysis

Cheng

Qiu

et al. 2017

Int Surg J

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INTRODUCTIONGBC was first reported more than two hundred years ago, but the poor therapeutic effect for GBC patients is still frustrating now, the 5-year survival rate is no more than 5%, and the mean survival time is only about half a year. 1 It still relies on surgical method to treat and provide the possibilities of favorable prognosis, while auxiliary methods like radiotherapy and chemotherapy are likely to reduce the chance of tumor relapse and improve the longterm survival of GBC patients. 2 GBC patients' survival time -one of the major indicators for prognosis judgment isn't affected by sexuality, age or ABSTRACT Background: GBC was first reported more than two hundred years ago, but the poor therapeutic effect for GBC patients is still frustrating now, the 5-year survival rate is no more than 5%, and the mean survival time is only about half a year. The objective of this study was to evaluate the importance of radical resection in the treatment of Nevin II and T1b stage gallbladder cancer (stage II GBC) by analyzing the survival rate and tumor recurrence rate after accepting simple cholecystectomy (SC) and radical resection (RR). Methods: PubMed, Embase, Chinese National Knowledge Infrastructure and Wanfang databases was searched from inception to February 2016. Quality assessment was conducted in each of the available studies by using the validated Newcastle-Ottawa Quality Assessment Scale (NOS) for cohort and case-control studies. Publication bias was also assessed by using a funnel plot. The odds ratio (OR) and its 95% confidence interval (95% CI) were employed to estimated effect size. All statistical analyses were carried out using Rev Man 5.2 software. Results: A total of fifteen studies encompassing 424 patients meeting the search criteria were included. Pooled analyses revealed that comparing to simple cholecystectomy, radical resection can significantly increase the 1-, 3-and 5-year survival rate of patients with stage II GBC (OR = 3.28, 95% CI: 1.83-5.89, P<0.0001; OR = 2.52, 95% CI: 1. P = 0.0006; OR = 3.19, P<0.0001), and patients after radical resection have a significant lower tumor recurrence rate (OR = 0.30, 95% CI: 0.11-0.80, P = 0.02). Conclusions:The short-and long-term survival rate of patients with stage II GBC following radical resection is obviously higher than that of patients receiving simple cholecystectomy, and the tumor recurrence rate is obviously lower. Radical resection would be a better choice for stage II GBC.

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Section: Sensitivity Analysis and Bias Identifymentioning

confidence: 79%

Section: Survival Rate Analysismentioning

confidence: 90%

Section: Characteristics Of Included Literatures and Quality Assessmentmentioning

confidence: 99%

Section: Survival Rate Analysismentioning

confidence: 99%

Section: Survival Rate Analysismentioning

confidence: 99%

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Simple cholecystectomy versus radical resection for stage Ⅱ gallbladder cancer: a meta-analysis

Cheng

Qiu

et al. 2017

Int Surg J

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Optimal surgical treatment in patients with T1b gallbladder cancer: An international multicenter study

Kim

Park

Kim

et al. 2018

J Hepato Biliary Pancreat

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Background There is no consensus on the optimal treatment of T1b gallbladder cancer (GBC) due to the lack of evidence and the difficulty of anatomy and pathological standardization. Methods A total of 272 patients with T1b GBC who underwent surgical resection at 14 centers with specialized hepatobiliary-pancreatic surgeons and pathologists in Korea, Japan, Chile, and the United States were studied. Clinical outcomes including diseasespecific survival (DSS) rates according to the types of surgery were analyzed. Results After excluding patients, the 237 qualifying patients consisted of 90 men and 147 women. Simple cholecystectomy (SC) was performed in 116 patients (48.9%) and extended cholecystectomy (EC) in 121 patients (51.1%). The overall 5-year DSS was 94.6%, and it was similar between SC and EC patients (93.7% vs. 95.5%, P = 0.496). The 5-year DSS was similar between SC and EC patients in America (82.3% vs. 100.0%, P = 0.249) as well as in Asia (98.6% vs. 95.2%, P = 0.690). The 5-year DSS also did not differ according to lymph node metastasis (P = 0.688) or tumor location (P = 0.474). Conclusions SC showed similar clinical outcomes (including recurrence) and survival outcomes as EC; therefore, EC is not needed for the treatment of T1b GBC.

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Assessing the impact of common bile duct resection in the surgical management of gallbladder cancer

Gani

Buettner

Margonis

et al. 2016

Journal of Surgical Oncology

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Background Although radical re-resection for gallbladder cancer (GBC) has been advocated, the optimal extent of re-resection remains unknown. The current study aimed to assess the impact of common bile duct (CBD) resection on survival among patients undergoing surgery for GBC. Methods Patients undergoing curative-intent surgery for GBC were identified using a multi-institutional cohort of patients. Multivariable Cox-proportional hazards regression was performed to identify risk factors for a poor overall survival (OS). Results Among the 449 patients identified, 26.9% underwent a concomitant CBD resection. The median number of lymph nodes harvested did not differ based on CBD resection (CBD, 4 [IQR: 2–9] vs. no CBD, 3 [IQR: 1–7], P =0.108). While patients who underwent a CBD resection had a worse OS, after adjusting for potential confounders, CBD resection did not impact OS (HR =1.40, 95%CI 0.87–2.27, P =0.170). Rather, the presence of advanced disease (T3: HR =3.11, 95%CI 1.22–7.96, P =0.018; T4: HR =7.24, 95%CI 1.70–30.85, P =0.007) and the presence of disease at the surgical margin (HR =2.58, 95%CI 1.26–5.31, P =0.010) were predictive of a worse OS. Conclusions CBD resection did not yield a higher lymph node count and was not associated with an improved survival. Routine CBD excision in the re-resection of GBC is unwarranted and should only be performed selectively.

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Managing the incidentally detected gallbladder cancer: Algorithms and controversies

Abstract: Laparoscopic cholecystectomy does not affect survival if implemented properly. Reoperation should have two objectives: R0 resection and clearance of the lymph nodes.

Cited by 59 publications

References 52 publications

Simple cholecystectomy versus radical resection for stage Ⅱ gallbladder cancer: a meta-analysis

Simple cholecystectomy versus radical resection for stage Ⅱ gallbladder cancer: a meta-analysis

Optimal surgical treatment in patients with T1b gallbladder cancer: An international multicenter study

Assessing the impact of common bile duct resection in the surgical management of gallbladder cancer

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