Year 2018 / Volume 110 / Number 8
Original
A retrospective analysis of patients with gallbladder cancer: surgical treatment and survival according to tumor stage

485-492

DOI: 10.17235/reed.2018.5435/2017

Iago Justo, Alberto Marcacuzco, Oana-Anisa Nutu, Alejandro Manrique, Jorge Calvo, Óscar Caso, Félix Cambra, Álvaro García-Sesma, Luis Carlos Jiménez-Romero,

Abstract
Introduction: gallbladder cancer is the most common biliary neoplasm and the sixth most common tumor of the digestive system. The disease has an ominous prognosis, with a 5-year survival rate of approximately 5%. It is usually diagnosed late and surgical resection is the only potential cure. Methods: a retrospective study was carried out in 92 patients with a pathological diagnosis of gallbladder cancer from January 2000 to January 2016. Results: the mean age of cases was 72 ± 11 years; 64 subjects were females and 28 were males. Symptoms at admission included abdominal pain (78%), anorexia (77%), nausea (76%) and jaundice (45%). Surgery was indicated in 92 (100%) patients and 59 (64%) underwent a curative/intent resection. The initial surgical procedures included simple cholecystectomy in 69 (75%) cases and extended cholecystectomy in eleven (11%) subjects. Rescue surgery was performed in 15 patients with tumor tissue in the cholecystectomy specimen; ten individuals underwent an R0 curative resection. Adjuvant therapy was administered in 30 (33%) patients. The median survival in our series was 12.5 months, with survival rates of 57%, 30% and 20% at one, three and five years, respectively. Conclusion: to conclude, surgical treatment with a complete tumor resection should be considered for all patients, provided that their clinical status allows it.
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1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin. 2017;67(1):7-30.
2. Hundal R, Schaffer EA. Gallbladder cancer: epidemiology and outcome. Clin Epidemiol. 2014;6:99-109
3. American Cancer Society. Cancer Facts & Figures 2017.
4. Wernberg JA, Lucarelli DD. Gallbladder cancer. Surg Clin North Am. 2014;94:342-60.
5. Duffy A, Capanu M, Abou-Alfa GK, et al. Gallbladder cancer (GBC): 10-year experience at Memorial Sloan-Kettering Cancer Centre (MSKCC). J Surg Oncol. 2008;98:485-89.
6. Fuks D, Regimbeau JM, Le Treut YP, et al. Incidental gallbladder cancer by the AFC-GBC Study Group. World J Surg. 2011;35:1887-97.
7. Pitt SC, Jin LX, Hall BL, et al. Incidental gallbladder cancer at cholecystectomy: when should the surgeon be suspicious? Ann Surg. 2014;260:128-33.
8. Choi KS, Choi SB, Park P, et al. Clinical characteristics of incidental or unsuspected gallbladder cancers diagnosed during or after cholecystectomy: a systematic review and meta-analysis. World J Gastroenterol. 2015;21:1315-23.
9. Vinuela E, Vega E, Yamashita S, et al. Incidental gallbladder cancer: residual cancer discovered at oncologic extended resection determines outcome: A report from high- and low-incidence countries. Ann Surg Oncol. 2017;24:2334-43.
10. Edge SB, Byrd DR, Compton CC, et al, editors. AJCC cancer staging manual (7th ed). New York, NY: Springer; 2010.
11. Randi G, Franceschi S, La Vecchia C. Gallbladder cancer worldwide: geographical distribution and risk factors. Int J Cancer. 2006;118:1591-602.
12. Goetze TO. Gallbladder carcinoma: Prognostic factors and therapeutic options. World J Gastroenterol. 2015;21(43):12211-17.
13. Misra S, Chaturvedi A, Misra NC, et al. Carcinoma of the gallbladder. Lancet Oncol. 2003;4(3):167-76.
14. Fong Y, Wagman L, Gonen M, et al. Evidence-based gallbladder cancer staging: changing cancer staging by analysis of data from the National Cancer Database. Ann Surg. 2006;243:767-71.
15. Ramirez CP, Suárez MA, Santoyo J, et al. Actualización del diagnostic y el tratamiento del cancer de vesicular biliar. Cir Esp. 2002;71:102-11.
16. Wang YF, Feng FL, Zhao XH, et al. World J Gastroenterol. 2014;20(14):4085-92.
17. Aloia TA, Járufe N, Javle M, et al. Gallbladder cancer: expert consensus statement. HPB (Oxford). 2015;17(8):681-90.
18. Löhe F, Meimarakis G, Schauer C, et al. The time of diagnosis impacts surgical management but not the outcome of patients with gallbladder carcinoma. Eur J Med Res. 2009; 14(8):345-51.
19. Lee SE, Jang JY, LIM CS, et al. World J Gastroenterol 2011; 17(2): 174-80.
20. Watson H, Dasari B, Wyatt J, et al. HBP (Oxford). 2017; 19(2):104-107.
21. Lee H, Choi DW, Park JY, et al. Surgical strategy for T2 gallbladder cancer according to tumor location. Ann Surg Oncol. 2015;22(8):2779-86.
22. Shindoh J, de Aretxabala X, Aloia TA, et al. Tumor location is a strong predictor of tumor progression and survival in T2 gallbladder cáncer: an international multicenter study. Ann Surg. 2015;261(4):733-9.
23. Lee W, Jeong CY, Jang JY, et al. Surgery. 2017;162(3):515-524.
24. Liu GJ, Li XH, Chen YX, et al. World J Gastroenterol. 2013;19(31):5150-8.
25. Sternby Eliard M, Lundgren L, Cahlin C, et al. Surgical treatment for gallbladder cancer – a systematic literature review. Scand J Gastroenterol. 2017;52(5):505-514.
26. Jung W, Jang JY, Kang MJ, et al. Effects of surgical methods and tumor location on survival and recurrence patterns after Curative resection in patients with T2 gallblader cancer. Gut Liver. 2016;10(1):140-6.
27. Gani F, Buettner S, Margonis GA, et al. Assessing the impact of common bile duct resection in the surgical management of gallbladder cancer. J Surg Oncol. 2016;114(2):176-80.
28. Kasumova GG, Tabatabaie O, Najarian RM, et al. Surgical Management of gallbladder cancer: Simple versus extended cholecystectomy and the role of adjuvant therapy. Ann Surg. 2017;226(4):625-31.
29. Kim Y, Amini N, Wilson A, et al. Impact of chemotherapy and external-beam radiation therapy on outcomes among patients with resected gallbladder cancer: A multi-institutional analysis. Ann Surg Oncol. 2016;23(9):2998-3008.
30. Wang J, Narang AK, Sugar EA, et al. Evaluation of adjuvant radiation therapy for resected gallbladder carcinoma: A multi - institutional experience. Ann Surg Oncol. 2015;22(suppl 3):S1100-6.
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Justo I, Marcacuzco A, Nutu O, Manrique A, Calvo J, Caso Ó, et all. A retrospective analysis of patients with gallbladder cancer: surgical treatment and survival according to tumor stage. 5435/2017


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Publication history

Received: 24/12/2017

Accepted: 03/02/2018

Online First: 12/04/2018

Published: 30/07/2018

Article revision time: 39 days

Article Online First time: 109 days

Article editing time: 218 days


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