The optimal extent of surgery in T2 gallbladder cancer and the need for hepatectomy: A meta-analysis

Burasakarn, Pipit; Thienhiran, Anuparp; Hongjinda, Sermsak; Fuengfoo, Pusit

doi:10.1016/j.asjsur.2021.05.005

Cited by 6 publications

(5 citation statements)

References 36 publications

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“…However, lymphs nodes of the first station would drain directly to the third station without going through the second station ( 23 ). Moreover, some studies have also shown that lymphatic metastasis of GBC occurred earlier than liver invasion ( 6 , 40 , 41 ), leading to the limited benefits of SR. These studies demonstrated that lymph nodes status strongly influenced the prognosis of GBC patients after surgery, and we would conduct in-depth meta-analysis based on the lymphs nodes status in future studies.…”

Section: Discussionmentioning

confidence: 99%

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Wedge resection versus segment IVb and V resection of the liver for T2 gallbladder cancer: a systematic review and meta-analysis

Chen

Cao

et al. 2023

Front. Oncol.

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ObjectivesAlthough guidelines recommend extended cholecystectomy for T2 gallbladder cancer (GBC), the optimal hepatectomy strategy remains controversial. The study aims to compare the prognosis of T2 GBC patients who underwent wedge resection (WR) versus segment IVb and V resection (SR) of the liver.MethodsA specific search of online databases was performed from May 2001 to February 2023. The postoperative efficacy outcomes were synthesized and meta-analyses were conducted.ResultsA total of 9 studies involving 2,086 (SR = 627, WR = 1,459) patients were included in the study. The primary outcomes included disease-free survival (DFS) and overall survival (OS). For DFS, the 1-year DFS was statistically higher in patients undergoing SR than WR [risk ratio (RR) = 1.07, 95% confidence interval (CI) = 1.02-1.13, P = 0.007]. The 3-year DFS (P = 0.95), 5-year DFS (P = 0.77), and hazard ratio (HR) of DFS (P = 0.72) were similar between the two groups. However, the 3-year OS was significantly lower in patients who underwent SR than WR [RR = 0.90, 95% CI = 0.82-0.99, P = 0.03]. Moreover, SR had a higher hazard HR of OS [HR = 1.33, 95% CI = 1.01-1.75, P = 0.04]. No significant difference was found in 1-year (P = 0.32) and 5-year (P = 0.9) OS. For secondary outcomes, patients who received SR tended to develop postoperative complications (POC) [RR = 1.90, 95% CI = 1.00-3.60, P = 0.05]. In addition, no significant differences in intrahepatic recurrence (P = 0.12) were observed.ConclusionsIn conclusion, SR can improve the prognosis of T2 GBC patients in DFS. In contrast to WR, the high HR and complications associated with SR cannot be neglected. Therefore, surgeons should evaluate the condition of the patients and take their surgical skills into account when selecting SR.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier, CRD42022362974.

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Section: Discussionmentioning

confidence: 99%

“…For instance, Burasakarn et al. ( 40 ) only compared the effect of simple cholecystectomy and radical resection, whereas Lee et al. ( 44 ) compared the effect of SR and WR for T1 GBC.…”

Section: Discussionmentioning

confidence: 99%

Wedge resection versus segment IVb and V resection of the liver for T2 gallbladder cancer: a systematic review and meta-analysis

Chen

Cao

et al. 2023

Front. Oncol.

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“…Recently, laparoscopic radical cholecystectomies have increased alongside an increasing amount of evidence for their oncological safety [11][12][13][14]. A recent paper has found that hepatectomies may not be required in T2 GBC if the preoperative evaluation con rms the depth of the tumor to be in the ss layer [15]. New methods for the diagnosis of PI preoperatively or intraoperatively are required.…”

Section: Discussionmentioning

confidence: 99%

T2 gallbladder carcinoma: Clinicopathological features and optimal surgical strategies

Endo

Amano

Orimoto

et al. 2022

Preprint

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Purpose: For gallbladder carcinomas (GBCs), the only effective treatment is surgery. In this study, we aimed to determine the clinicopathologicalfeatures of T2 GBC and identify the optimal surgical strategies. Methods: This was a retrospectivestudy of 77 patients with histologically verified T2 subserosal GBC who underwent surgery at our institution between 1989 and 2021. Pathological data (tumor size, location, grade, lymph node status, and lymphovascular and perineural invasions) and demographic data were reviewed. The 5-year disease-specific survival (DSS) rates were determined and included in our analysis. Results: The 42 (55%) patients in our sample who were pathological invasion (PI)-positive had significantly lower 5-year DSS. PI was significantly correlated with lymph node metastasis but not with tumor location. Those with PI treated with radical cholecystectomies had better 5-year DSS rates than those treated with simple cholecystectomies (57% vs 25%, p = 0.04). However, different surgical procedures produced no significant differences in the 5-year DSS of PI-negative patients. Conclusions: PI-positive T2 GBC patients had poor prognoses and required radical cholecystectomy. However, PI-negative cases had low lymph node metastases rates and favorable prognoses. In these cases, simple cholecystectomy may be more appropriate.

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“…Gallbladder cancer is a rare cancer that is aggressive and is associated with a poor prognosis (Burasakarn et al, 2021). The 5-year survival is extremely low in advanced cases (Kai et al, 2007).…”

Section: Obesity and Gall Bladder Cancermentioning

confidence: 99%

Obesity and Its Relationship With Cancer: Part Iii

2021

aijcs

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Obesity and cancer has been discussed in the first two parts. This part (Part III) deals with six cancers, namely those involving the breast, colorectal tissues, esophagus, stomach. gall bladder, and liver. Their relationship with obesity is discussed. Part IV will look at endometrial, ovarian, pancreatic, prostate, renal, thyroid and lung carcinomas. Meningioma and multiple myeloma are also discussed.

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The optimal extent of surgery in T2 gallbladder cancer and the need for hepatectomy: A meta-analysis

Cited by 6 publications

References 36 publications

Wedge resection versus segment IVb and V resection of the liver for T2 gallbladder cancer: a systematic review and meta-analysis

Wedge resection versus segment IVb and V resection of the liver for T2 gallbladder cancer: a systematic review and meta-analysis

T2 gallbladder carcinoma: Clinicopathological features and optimal surgical strategies

Obesity and Its Relationship With Cancer: Part Iii

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