TY - JOUR
T1 - Tumor location is a strong predictor of tumor progression and survival in T2 gallbladder cancer
T2 - An international multicenter study
AU - Shindoh, Junichi
AU - De Aretxabala, Xabier
AU - Aloia, Thomas A.
AU - Roa, Juan Carlos
AU - Roa, Ivan
AU - Zimmitti, Giuseppe
AU - Javle, Milind
AU - Conrad, Claudius
AU - Maru, Dipen M.
AU - Aoki, Taku
AU - Vigano, Luca
AU - Ribero, Dario
AU - Kokudo, Norihiro
AU - Capussotti, Lorenzo
AU - Vauthey, Jean Nicolas
N1 - Publisher Copyright:
Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2015/4
Y1 - 2015/4
N2 - Objective: To determine the prognostic impact of tumor location in gallbladder cancer. Background: Depth of tumor is a strong predictor of survival after curative resection of gallbladder cancer.However, the gallbladder has a unique anatomical relationship with the liver, and the clinical significance of tumor location remains unclear. Methods: For 437 patients with gallbladder cancer who underwent resection at 4 international institutions, clinicopathologic characteristics and their association with survival were analyzed. Tumor location was defined as "hepatic side" or "peritoneal side," and the prognostic significance of tumor location was evaluated. Results: Among the 252 patients with T2 disease, patients with tumors on the hepatic side (T2h, n = 99) had higher rates of vascular invasion, neural invasion, and nodal metastasis than patients with tumors on the peritoneal side (T2p, n = 153) (51% vs 19%, 33% vs 8%, and 40% vs 17%, respectively; P < 0.01 for all). After a median follow-up of 58.9 months, 3-year and 5-year survival rates were 52.1% and 42.6%, respectively, for T2h tumors and 73.7% and 64.7%, respectively, for T2p tumors (P = 0.0006). No such differences were observed in T1 or T3 tumors. Multivariate analysis confirmed the independent association of hepatic-side location with survival in T2 tumors (hazard ratio, 2.7; 95% confidence interval, 1.7-4.2; P < 0.001). This subclassification of T2 tumors predicted recurrence in the liver (23% vs 3%; P = 0.003) and distant lymph nodes (16% vs 3%; P = 0.019) even after radical resection. Conclusions: After curative resection of T2 gallbladder cancer, tumor location predicts the pattern of recurrence and survival.
AB - Objective: To determine the prognostic impact of tumor location in gallbladder cancer. Background: Depth of tumor is a strong predictor of survival after curative resection of gallbladder cancer.However, the gallbladder has a unique anatomical relationship with the liver, and the clinical significance of tumor location remains unclear. Methods: For 437 patients with gallbladder cancer who underwent resection at 4 international institutions, clinicopathologic characteristics and their association with survival were analyzed. Tumor location was defined as "hepatic side" or "peritoneal side," and the prognostic significance of tumor location was evaluated. Results: Among the 252 patients with T2 disease, patients with tumors on the hepatic side (T2h, n = 99) had higher rates of vascular invasion, neural invasion, and nodal metastasis than patients with tumors on the peritoneal side (T2p, n = 153) (51% vs 19%, 33% vs 8%, and 40% vs 17%, respectively; P < 0.01 for all). After a median follow-up of 58.9 months, 3-year and 5-year survival rates were 52.1% and 42.6%, respectively, for T2h tumors and 73.7% and 64.7%, respectively, for T2p tumors (P = 0.0006). No such differences were observed in T1 or T3 tumors. Multivariate analysis confirmed the independent association of hepatic-side location with survival in T2 tumors (hazard ratio, 2.7; 95% confidence interval, 1.7-4.2; P < 0.001). This subclassification of T2 tumors predicted recurrence in the liver (23% vs 3%; P = 0.003) and distant lymph nodes (16% vs 3%; P = 0.019) even after radical resection. Conclusions: After curative resection of T2 gallbladder cancer, tumor location predicts the pattern of recurrence and survival.
KW - Gallbladder cancer
KW - Predictor
KW - Staging
KW - Tumor location
KW - Tumor progression
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U2 - 10.1097/SLA.0000000000000728
DO - 10.1097/SLA.0000000000000728
M3 - Article
C2 - 24854451
AN - SCOPUS:84928548105
SN - 0003-4932
VL - 261
SP - 733
EP - 739
JO - Annals of surgery
JF - Annals of surgery
IS - 4
ER -