Surgical treatment for gallbladder cancer – a systematic literature review

Eilard, Malin Sternby; Lundgren, Linda; Cahlin, Christian; Strandell, Annika; Svanberg, Therese; Sandström, Per

doi:10.1080/00365521.2017.1284895

Cited by 54 publications

(50 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Swedish national guidelines recommend re‐resection of T1b incidental gallbladder cancer. This was also supported by a recent systematic review, but with a very low certainty of evidence. Some studies favoured re‐resection for T1b incidental gallbladder cancer, whereas others have not reported any benefit of re‐resection in this patient group.…”

Section: Discussionsupporting

confidence: 58%

“…Provided that the patient is medically fit for surgery, previous data support re‐resection of T1b, T2 and T3 incidental cancers to improve survival. Re‐resection includes partial hepatectomy of segments IVb and V, either as wedge resection or bisegmentectomy, and lymph node dissection. More extended liver resection is recommended only to achieve R0 margins, and common bile duct resection is usually undertaken only if cystic duct margins are positive.…”

Section: Introductionmentioning

confidence: 99%

“…However, cholecystectomies are carried out in more than 60 hospitals. Since 2013, Swedish national guidelines have been provided for gallbladder cancer, and a review of surgical treatment of gallbladder cancer has been published. However, there is a lack of knowledge regarding the actual management of patients with incidental gallbladder cancer in Sweden.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Management of incidental gallbladder cancer in a national cohort

Lundgren

Muszynska

Ros

et al. 2019

British Journal of Surgery

View full text Add to dashboard Cite

Background Incidental gallbladder cancer is a rare event, and its prognosis is largely affected by the tumour stage and treatment. The aim of this study was to analyse the management, treatment and survival of patients with incidental gallbladder cancer in a national cohort over a decade. Methods Patients were identified through the Swedish Registry of Gallstone Surgery (GallRiks). Data were cross‐linked to the national registry for liver surgery (SweLiv) and the Cancer Registry. Medical records were collected if registry data were missing. Survival was measured as disease‐specific survival. The study was divided into two intervals (2007–2011 and 2012–2016) to evaluate changes over time. Results In total, 249 patients were identified with incidental gallbladder cancer, of whom 92 (36·9 per cent) underwent re‐resection with curative intent. For patients with pT2 and pT3 disease, median disease‐specific survival improved after re‐resection (12·4 versus 44·1 months for pT2, and 9·7 versus 23·0 months for pT3). Residual disease was present in 53 per cent of patients with pT2 tumours who underwent re‐resection; these patients had a median disease‐specific survival of 32·2 months, whereas the median was not reached in patients without residual disease. Median survival increased by 11 months for all patients between the early and late periods (P = 0·030). Conclusion Re‐resection of pT2 and pT3 incidental gallbladder cancer was associated with improved survival, but survival was impaired when residual disease was present. A higher re‐resection rate and more R0 resections in the later time period may have been associated with improved survival.

show abstract

Section: Discussionsupporting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Management of incidental gallbladder cancer in a national cohort

Lundgren

Muszynska

Ros

et al. 2019

British Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Its relevance for survival and staging is recognized and allows to differentiate standard lymphadenectomy (confined to the hepatoduodenal ligament) from extended lymphadenectomy (celiac trunk, interaorto-caval space, etc. ), with improved survival in the latter (24,25). In our series, regional lymphadenectomy was performed in all patients undergoing an extended cholecystectomy.…”

Section: Discussionmentioning

confidence: 99%

A retrospective analysis of patients with gallbladder cancer: surgical treatment and survival according to tumor stage

Alonso¹,

Marcacuzco²,

Nutu³

et al. 2018

Rev Esp Enferm Dig

View full text Add to dashboard Cite

“…Management of incidental gallbladder cancer must take several factors into account for decision-making ( Fig. 3), despite evidence for best management being based on poor-quality data 17,19,21,89 .…”

Section: Type and Extent Of Reresectionmentioning

confidence: 99%

Systematic review of management of incidental gallbladder cancer after cholecystectomy

Søreide

Guest

Harrison

et al. 2019

Journal of British Surgery

107

View full text Add to dashboard Cite

Background Gallbladder cancer is rare, but cancers detected incidentally after cholecystectomy are increasing. The aim of this study was to review the available data for current best practice for optimal management of incidental gallbladder cancer. Methods A systematic PubMed search of the English literature to May 2018 was conducted. Results The search identified 12 systematic reviews and meta‐analyses, in addition to several consensus reports, multi‐institutional series and national audits. Some 0·25–0·89 per cent of all cholecystectomy specimens had incidental gallbladder cancer on pathological examination. Most patients were staged with pT2 (about half) or pT1 (about one‐third) cancers. Patients with cancers confined to the mucosa (T1a or less) had 5‐year survival rates of up to 100 per cent after cholecystectomy alone. For cancers invading the muscle layer of the gallbladder wall (T1b or above), reresection is recommended. The type, extent and timing of reresection remain controversial. Observation time may be used for new cross‐sectional imaging with CT and MRI. Perforation at initial surgery had a higher risk of disease dissemination. Gallbladder cancers are PET‐avid, and PET may detect residual disease and thus prevent unnecessary surgery. Routine laparoscopic staging before reresection is not warranted for all stages. Risk of peritoneal carcinomatosis increases with each T category. The incidence of port‐site metastases is about 10 per cent. Routine resection of port sites has no effect on survival. Adjuvant chemotherapy is poorly documented and probably underused. Conclusion Management of incidental gallbladder cancer continues to evolve, with more refined suggestions for subgroups at risk and a selective approach to reresection.

show abstract

Surgical treatment for gallbladder cancer – a systematic literature review

Abstract: Data indicate that prognosis can be improved if liver resection and lymph node resection is performed in patients with tumour stage T1b or higher. There is no evidence supporting resection of the bile duct or adjacent organs if it is not necessary in order to achieve radicality.

Cited by 54 publications

References 66 publications

Management of incidental gallbladder cancer in a national cohort

Management of incidental gallbladder cancer in a national cohort

A retrospective analysis of patients with gallbladder cancer: surgical treatment and survival according to tumor stage

Systematic review of management of incidental gallbladder cancer after cholecystectomy

Contact Info

Product

Resources

About