TY - JOUR
T1 - Incidental versus non-incidental gallbladder cancer
T2 - index cholecystectomy before oncologic re-resection negatively impacts survival in T2b tumors
AU - Vega, Eduardo A.
AU - Vinuela, Eduardo
AU - Okuno, Masayuki
AU - Joechle, Katharina
AU - Sanhueza, Marcel
AU - Diaz, Cristian
AU - Jarufe, Nicolas
AU - Martinez, J.
AU - Troncoso, Andres
AU - Diaz, Alfonso
AU - Chun, Y. S.
AU - Tzeng, Ching Wei D.
AU - Lee, Jeffrey E.
AU - Vauthey, Jean Nicolas
AU - Conrad, Claudius
N1 - Publisher Copyright:
© 2019
PY - 2019/8
Y1 - 2019/8
N2 - Background: Conflicting data exists whether non-oncologic index cholecystectomy (IC) leading to discovery of incidental gallbladder cancer (IGBC) negatively impacts survival. This study aimed to determine whether a subgroup of patients derives a disadvantage from IC. Methods: Patients with IGBC and non-IGBC treated at an academic USA and Chilean center during 1999–2016 were compared. Patients with T1, T4 tumor or preoperative jaundice were excluded. T2 disease was classified into T2a (peritoneal-side tumor) and T2b (hepatic-side tumor). Disease-specific survival (DSS) and its predictors were analyzed. Results: Of the 196 patients included, 151 (77%) had IGBC. One hundred thirty-six (90%) patients of whom 118 (87%) had IGBC had T2 disease. Three-year DSS rates were similar between IGBC and non-IGBC for all patients. However, for T2b patients, 3-year survival rate was worse for IGBC (31% vs 85%; p = 0.019). In multivariate analysis of T2 patients, predictors of poor DSS were hepatic-side tumor hazard ratio [HR], 2.9; 95% CI, 1.6–5.4; p = 0.001) and N1 status (HR, 2.4; 95% CI, 1.6–3.6; p < 0.001). Conclusions: Patients with T2b gallbladder cancer specifically benefit from a single operation. These patients should be identified preoperatively and referred to hepatobiliary center.
AB - Background: Conflicting data exists whether non-oncologic index cholecystectomy (IC) leading to discovery of incidental gallbladder cancer (IGBC) negatively impacts survival. This study aimed to determine whether a subgroup of patients derives a disadvantage from IC. Methods: Patients with IGBC and non-IGBC treated at an academic USA and Chilean center during 1999–2016 were compared. Patients with T1, T4 tumor or preoperative jaundice were excluded. T2 disease was classified into T2a (peritoneal-side tumor) and T2b (hepatic-side tumor). Disease-specific survival (DSS) and its predictors were analyzed. Results: Of the 196 patients included, 151 (77%) had IGBC. One hundred thirty-six (90%) patients of whom 118 (87%) had IGBC had T2 disease. Three-year DSS rates were similar between IGBC and non-IGBC for all patients. However, for T2b patients, 3-year survival rate was worse for IGBC (31% vs 85%; p = 0.019). In multivariate analysis of T2 patients, predictors of poor DSS were hepatic-side tumor hazard ratio [HR], 2.9; 95% CI, 1.6–5.4; p = 0.001) and N1 status (HR, 2.4; 95% CI, 1.6–3.6; p < 0.001). Conclusions: Patients with T2b gallbladder cancer specifically benefit from a single operation. These patients should be identified preoperatively and referred to hepatobiliary center.
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U2 - 10.1016/j.hpb.2018.12.006
DO - 10.1016/j.hpb.2018.12.006
M3 - Article
C2 - 30711243
AN - SCOPUS:85060758677
SN - 1365-182X
VL - 21
SP - 1046
EP - 1056
JO - HPB
JF - HPB
IS - 8
ER -