Predictors of curative resection and long term survival of gallbladder cancer – A retrospective analysis
Abstract Background Gallbladder cancer (GBC) is an aggressive malignancy. We analysed factors predicting resectability and survival of patients with GBC and the impact of surgical obstructive jaundice (SOJ). Methods Four hundred and thirty-seven patients with suspected GBC were analysed (52 excluded...
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| Veröffentlicht in: | The American journal of surgery 2017-08, Vol.214 (2), p.278-286 |
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| creator | Mishra, Pramod Kumar Saluja, Sundeep Singh Prithiviraj, Nabi Varshney, Vaibhav Goel, Neeraj Patil, Nilesh |
| description | Abstract Background Gallbladder cancer (GBC) is an aggressive malignancy. We analysed factors predicting resectability and survival of patients with GBC and the impact of surgical obstructive jaundice (SOJ). Methods Four hundred and thirty-seven patients with suspected GBC were analysed (52 excluded: benign pathology n = 35, missed GBC n = 17). The remaining 385 patients were divided into non-SOJ (n = 234) and SOJ (n = 151) groups. Predictors of resectability and long term survival were analysed and compared with their subgroups. Results Patients with gastric outlet obstruction, abdominal lump, weight loss and SOJ were more likely to be unresectable (p:0.04, 0.024, 0.003 and 0.003, respectively). TNM stage, node positivity and adjacent organ involvement were predictors of survival (p |
| doi_str_mv | 10.1016/j.amjsurg.2017.02.006 |
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We analysed factors predicting resectability and survival of patients with GBC and the impact of surgical obstructive jaundice (SOJ). Methods Four hundred and thirty-seven patients with suspected GBC were analysed (52 excluded: benign pathology n = 35, missed GBC n = 17). The remaining 385 patients were divided into non-SOJ (n = 234) and SOJ (n = 151) groups. Predictors of resectability and long term survival were analysed and compared with their subgroups. Results Patients with gastric outlet obstruction, abdominal lump, weight loss and SOJ were more likely to be unresectable (p:0.04, 0.024, 0.003 and 0.003, respectively). TNM stage, node positivity and adjacent organ involvement were predictors of survival (p < 0.001, 0.008 and <0.001). Metastatic (36.7% vs 47.7%), inoperable (1.7% vs 12.6%) and unresectable disease (9.8% vs 24.5%) were more in the SOJ group and had lower curative resection rates (51.7% vs 15.2%; p < 0.0001). The 1,2 and 5-year survival rates were higher in patients in the non-SOJ than SOJ group (79.6%, 65% and 52.9% vs 48.6, 32.4% and 0%; p < 0.001). Conclusion GBC with SOJ is more likely to be unresectable. SOJ, nodal involvement, adjacent organ infiltration and higher TNM stage predict poor survival.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2017.02.006</identifier><identifier>PMID: 28233537</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Abdomen ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Benign ; Bile ; Biopsy ; Cancer ; Carcinoma gallbladder ; Endoscopy ; Female ; Gallbladder ; Gallbladder cancer ; Gallbladder Neoplasms - complications ; Gallbladder Neoplasms - mortality ; Gallbladder Neoplasms - surgery ; Humans ; Infiltration ; Jaundice ; Jaundice, Obstructive - etiology ; Jaundice, Obstructive - mortality ; Jaundice, Obstructive - surgery ; Laparoscopy ; Liver ; Lymphatic system ; Male ; Malignancy ; Medical prognosis ; Metastases ; Metastasis ; Middle Aged ; Morbidity ; Mortality ; Patients ; Predictors of resectability ; Prognosis ; Radical cholecystectomy ; Remission Induction ; Resectability in gallbladder cancer ; Retrospective Studies ; Subgroups ; Surgery ; Surgical obstructive jaundice ; Surgical outcomes ; Survival ; Survival Rate ; Time Factors ; Ultrasonic imaging ; Weight loss ; Young Adult</subject><ispartof>The American journal of surgery, 2017-08, Vol.214 (2), p.278-286</ispartof><rights>Elsevier Inc.</rights><rights>2017 Elsevier Inc.</rights><rights>Copyright © 2017 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Aug 1, 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c514t-bed6a6d8a009cee6cbddd7189356338b009e19a1461583320d7a9c8f69db73653</citedby><cites>FETCH-LOGICAL-c514t-bed6a6d8a009cee6cbddd7189356338b009e19a1461583320d7a9c8f69db73653</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1922853535?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72341</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28233537$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mishra, Pramod Kumar</creatorcontrib><creatorcontrib>Saluja, Sundeep Singh</creatorcontrib><creatorcontrib>Prithiviraj, Nabi</creatorcontrib><creatorcontrib>Varshney, Vaibhav</creatorcontrib><creatorcontrib>Goel, Neeraj</creatorcontrib><creatorcontrib>Patil, Nilesh</creatorcontrib><title>Predictors of curative resection and long term survival of gallbladder cancer – A retrospective analysis</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Abstract Background Gallbladder cancer (GBC) is an aggressive malignancy. We analysed factors predicting resectability and survival of patients with GBC and the impact of surgical obstructive jaundice (SOJ). Methods Four hundred and thirty-seven patients with suspected GBC were analysed (52 excluded: benign pathology n = 35, missed GBC n = 17). The remaining 385 patients were divided into non-SOJ (n = 234) and SOJ (n = 151) groups. Predictors of resectability and long term survival were analysed and compared with their subgroups. Results Patients with gastric outlet obstruction, abdominal lump, weight loss and SOJ were more likely to be unresectable (p:0.04, 0.024, 0.003 and 0.003, respectively). TNM stage, node positivity and adjacent organ involvement were predictors of survival (p < 0.001, 0.008 and <0.001). Metastatic (36.7% vs 47.7%), inoperable (1.7% vs 12.6%) and unresectable disease (9.8% vs 24.5%) were more in the SOJ group and had lower curative resection rates (51.7% vs 15.2%; p < 0.0001). The 1,2 and 5-year survival rates were higher in patients in the non-SOJ than SOJ group (79.6%, 65% and 52.9% vs 48.6, 32.4% and 0%; p < 0.001). Conclusion GBC with SOJ is more likely to be unresectable. SOJ, nodal involvement, adjacent organ infiltration and higher TNM stage predict poor survival.</description><subject>Abdomen</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Benign</subject><subject>Bile</subject><subject>Biopsy</subject><subject>Cancer</subject><subject>Carcinoma gallbladder</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Gallbladder</subject><subject>Gallbladder cancer</subject><subject>Gallbladder Neoplasms - complications</subject><subject>Gallbladder Neoplasms - mortality</subject><subject>Gallbladder Neoplasms - surgery</subject><subject>Humans</subject><subject>Infiltration</subject><subject>Jaundice</subject><subject>Jaundice, Obstructive - etiology</subject><subject>Jaundice, Obstructive - mortality</subject><subject>Jaundice, Obstructive - surgery</subject><subject>Laparoscopy</subject><subject>Liver</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Malignancy</subject><subject>Medical prognosis</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Patients</subject><subject>Predictors of resectability</subject><subject>Prognosis</subject><subject>Radical cholecystectomy</subject><subject>Remission Induction</subject><subject>Resectability in gallbladder cancer</subject><subject>Retrospective Studies</subject><subject>Subgroups</subject><subject>Surgery</subject><subject>Surgical obstructive jaundice</subject><subject>Surgical outcomes</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>Time Factors</subject><subject>Ultrasonic imaging</subject><subject>Weight loss</subject><subject>Young Adult</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFUsuKFDEUDaI4besnKAVu3FSZR1cqtVGGwRcMzIC6DqnkdpMyVWmTqobezT_4h36Jt-jWgdlIFpeEc86995wQ8pLRilEm3_aVGfo8p13FKWsqyitK5SOyYqppS6aUeExWlFJetpLRC_Is5x6vjG3EU3LBFReiFs2K9LcJnLdTTLmI28LOyUz-AEWCDHbycSzM6IoQx10xQRoK7HjwBxMW8M6E0AXjHKTCmtFi-X33q7hE8pRi3i8CKGVGE47Z5-fkydaEDC_OdU2-f_zw7epzeX3z6cvV5XVpa7aZyg6cNNIpQ2lrAaTtnHMNU62opRCqw2dgrWEbyWolBKeuMa1VW9m6rhGyFmvy5qS7T_HnDHnSg88WQjAjxDlrdIjXjap5g9DXD6B9nBPOi6iWc1WL5axJfUJZ3Con2Op98oNJR82oXsLQvT6HoZcwNOUaw0Deq7P63A3g_rH-uo-A9ycAoB0HD0ln6wGNdD6hedpF_98W7x4o2OBHb034AUfI99vojAT9dfkRy4dgUlAlcYQ_PkyzxQ</recordid><startdate>20170801</startdate><enddate>20170801</enddate><creator>Mishra, Pramod Kumar</creator><creator>Saluja, Sundeep Singh</creator><creator>Prithiviraj, Nabi</creator><creator>Varshney, Vaibhav</creator><creator>Goel, Neeraj</creator><creator>Patil, Nilesh</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20170801</creationdate><title>Predictors of curative resection and long term survival of gallbladder cancer – A retrospective analysis</title><author>Mishra, Pramod Kumar ; Saluja, Sundeep Singh ; Prithiviraj, Nabi ; Varshney, Vaibhav ; Goel, Neeraj ; Patil, Nilesh</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c514t-bed6a6d8a009cee6cbddd7189356338b009e19a1461583320d7a9c8f69db73653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Abdomen</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Benign</topic><topic>Bile</topic><topic>Biopsy</topic><topic>Cancer</topic><topic>Carcinoma gallbladder</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Gallbladder</topic><topic>Gallbladder cancer</topic><topic>Gallbladder Neoplasms - complications</topic><topic>Gallbladder Neoplasms - mortality</topic><topic>Gallbladder Neoplasms - surgery</topic><topic>Humans</topic><topic>Infiltration</topic><topic>Jaundice</topic><topic>Jaundice, Obstructive - etiology</topic><topic>Jaundice, Obstructive - mortality</topic><topic>Jaundice, Obstructive - surgery</topic><topic>Laparoscopy</topic><topic>Liver</topic><topic>Lymphatic system</topic><topic>Male</topic><topic>Malignancy</topic><topic>Medical prognosis</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Patients</topic><topic>Predictors of resectability</topic><topic>Prognosis</topic><topic>Radical cholecystectomy</topic><topic>Remission Induction</topic><topic>Resectability in gallbladder cancer</topic><topic>Retrospective Studies</topic><topic>Subgroups</topic><topic>Surgery</topic><topic>Surgical obstructive jaundice</topic><topic>Surgical outcomes</topic><topic>Survival</topic><topic>Survival Rate</topic><topic>Time Factors</topic><topic>Ultrasonic imaging</topic><topic>Weight loss</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mishra, Pramod Kumar</creatorcontrib><creatorcontrib>Saluja, Sundeep Singh</creatorcontrib><creatorcontrib>Prithiviraj, Nabi</creatorcontrib><creatorcontrib>Varshney, Vaibhav</creatorcontrib><creatorcontrib>Goel, Neeraj</creatorcontrib><creatorcontrib>Patil, Nilesh</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Research Library (ProQuest)</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mishra, Pramod Kumar</au><au>Saluja, Sundeep Singh</au><au>Prithiviraj, Nabi</au><au>Varshney, Vaibhav</au><au>Goel, Neeraj</au><au>Patil, Nilesh</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of curative resection and long term survival of gallbladder cancer – A retrospective analysis</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2017-08-01</date><risdate>2017</risdate><volume>214</volume><issue>2</issue><spage>278</spage><epage>286</epage><pages>278-286</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>Abstract Background Gallbladder cancer (GBC) is an aggressive malignancy. We analysed factors predicting resectability and survival of patients with GBC and the impact of surgical obstructive jaundice (SOJ). Methods Four hundred and thirty-seven patients with suspected GBC were analysed (52 excluded: benign pathology n = 35, missed GBC n = 17). The remaining 385 patients were divided into non-SOJ (n = 234) and SOJ (n = 151) groups. Predictors of resectability and long term survival were analysed and compared with their subgroups. Results Patients with gastric outlet obstruction, abdominal lump, weight loss and SOJ were more likely to be unresectable (p:0.04, 0.024, 0.003 and 0.003, respectively). TNM stage, node positivity and adjacent organ involvement were predictors of survival (p < 0.001, 0.008 and <0.001). Metastatic (36.7% vs 47.7%), inoperable (1.7% vs 12.6%) and unresectable disease (9.8% vs 24.5%) were more in the SOJ group and had lower curative resection rates (51.7% vs 15.2%; p < 0.0001). The 1,2 and 5-year survival rates were higher in patients in the non-SOJ than SOJ group (79.6%, 65% and 52.9% vs 48.6, 32.4% and 0%; p < 0.001). Conclusion GBC with SOJ is more likely to be unresectable. SOJ, nodal involvement, adjacent organ infiltration and higher TNM stage predict poor survival.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28233537</pmid><doi>10.1016/j.amjsurg.2017.02.006</doi><tpages>9</tpages></addata></record> |
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| subjects | Abdomen Adolescent Adult Aged Aged, 80 and over Benign Bile Biopsy Cancer Carcinoma gallbladder Endoscopy Female Gallbladder Gallbladder cancer Gallbladder Neoplasms - complications Gallbladder Neoplasms - mortality Gallbladder Neoplasms - surgery Humans Infiltration Jaundice Jaundice, Obstructive - etiology Jaundice, Obstructive - mortality Jaundice, Obstructive - surgery Laparoscopy Liver Lymphatic system Male Malignancy Medical prognosis Metastases Metastasis Middle Aged Morbidity Mortality Patients Predictors of resectability Prognosis Radical cholecystectomy Remission Induction Resectability in gallbladder cancer Retrospective Studies Subgroups Surgery Surgical obstructive jaundice Surgical outcomes Survival Survival Rate Time Factors Ultrasonic imaging Weight loss Young Adult |
| title | Predictors of curative resection and long term survival of gallbladder cancer – A retrospective analysis |
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