DOI QR코드

DOI QR Code

Prognosis and Management for Gallbladder Cancer with Hepatic Invasion: Long-term Results of 139 Patients from a Single Center in China

  • Qu, Kai (Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University) ;
  • Chang, Hu-Lin (Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University) ;
  • Liu, Si-Nan (Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University) ;
  • Liu, Chang (Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University) ;
  • Xu, Xin-Sen (Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University) ;
  • Wang, Rui-Tao (Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University) ;
  • Zhou, Lei (Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University) ;
  • Tian, Feng (Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University) ;
  • Wei, Ji-Chao (Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University) ;
  • Tai, Ming-Hui (Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University) ;
  • Meng, Fan-Di (Department of Hepatobiliary Surgery, The First Affiliated Hospital of Medical College, Xi'an Jiaotong University)
  • Published : 2012.03.31

Abstract

Objective: To improve the diagnosis of primary gallbladder carcinoma (GBC) with/without hepatic metastases by analyzing our experience of different GBC treatment in our patients. Methods: A retrospective study was carried out to analyze the clinical data of the 139 patients with GBC who underwent hepatic resection in our unit from January 2003 to December 2007. Patients were divided into two groups according to whether they demonstrated hepatic invasion. Tumor presentation, surgical modes, and prognosis of each patient were retrospectively reviewed. Kaplan-Meier curves and log-rank tests were employed to compare the survival rates of those patients undergoing different surgical procedures. Results: Of the 139 patients, 46 were men and 93 were women with the male to female ratio of 1:2.0. Their ages were ranged from 35 to 86 years with a mean age of $62.8{\pm}10.4$ years. There were 73 patients complicated with hepatic invasion (group A), and no hepatic invasion occurred in the other 66 patients (group B). Compared with the group B, the patients with hepatic invasion suffered lower differentiation of tumor (p=0.000), more advanced Nevin staging (p=0.008) and poorer prognosis (p=0.013). Radical resection were more frequently performed in group B (75.76%) than in group A (45.20%) with better outcomes (p=0.000). Conclusion: GBC patients complicated with hepatic invasion had poorer prognosis than those without invasion in long-term follow-ups. Radical resection might result in a satisfied prognosis in patients without hepatic invasion, but appears less favorable than palliative resection in those who were complicated with hepatic invasion.

Keywords

References

  1. Boerma EJ (1994). Towards an oncological resection ofgall bladder cancer. Eur J Surg Oncol, 20, 537-44.
  2. Dixon E, Vollmer CM, Jr, Sahajpal A, et al (2005). An aggressive surgical approach leads to improved survival in patients with gallbladder cancer: a 12-year study at a North American Center. Ann Surg, 241, 385-94. https://doi.org/10.1097/01.sla.0000154118.07704.ef
  3. D'Angelica M, Dalal KM, DeMatteo RP, et al (2009). Analysis of the extent of resection or denocarcinoma of he gallbladder. Ann Surg Oncol, 16, 806-16. https://doi.org/10.1245/s10434-008-0189-3
  4. Fong Y, Jarnagin W, Blumgart LH (2000). Gallbladder cancer: comparison of patients presenting initially for definitive operation with those presenting after prior noncurative intervention. Ann Surg, 232, 557-69. https://doi.org/10.1097/00000658-200010000-00011
  5. Gourgiotis S, Kocher HM, Solaini L, et al (2008). Gallbladder cancer. Am J Surg, 196, 252-64. https://doi.org/10.1016/j.amjsurg.2007.11.011
  6. Ishikawa T, Horimi T, Shima Y, et al (2003). Evaluation of aggressive surgical treatment for advanced carcinoma of the gallbladder. J Hepatobiliary Pancreat Surg, 10, 233-8. https://doi.org/10.1007/s00534-003-0848-5
  7. Kokudo N, Makuuchi M, Natori T, et al (2003). Strategies for surgical treatment of gallbladder carcinoma based on information available before resection. Arch Surg, 138, 741-50. https://doi.org/10.1001/archsurg.138.7.741
  8. Lazcano-Ponce EC, Miquel JF, Muñoz N, et al (2001). Epidemiology and molecular pathology of gallbladder cancer. CA Cancer J Clin, 51, 349-64. https://doi.org/10.3322/canjclin.51.6.349
  9. Lin HT, Liu GJ, Wu D, et al (2005). Metastasis of primary gallbladder carcinoma in lymph node and liver. World J Gastroenterol, 11, 748-51. https://doi.org/10.3748/wjg.v11.i5.748
  10. Meng H, Wang X, Fong Y, et al (2011). Outcomes of radical surgery for gallbladder cancer patients with lymphatic metastases. Jpn J Clin Oncol, 41, 992-8. https://doi.org/10.1093/jjco/hyr072
  11. Moore MA, Attasara P, Khuhaprema T, et al (2010). Cancer epidemiology in mainland South-East Asia - past, present and future. Asian Pac J Cancer Prev, 11, 67-80.
  12. Nishio H, Nagino M, Ebata T, et al (2007). Aggressive surgery for stage IV gallbladder carcinoma; what are the contraindications? J Hepatobiliary Pancreat Surg, 14, 351-7. https://doi.org/10.1007/s00534-006-1187-0
  13. Ogura Y, Tabata M, Kawarada Y, et al (1998). Effect of hepatic invasion on the choice of hepatic resection for advanced carcinoma of the gallbladder: histologic analysis of 32 surgical cases. World J Surg, 22, 266-7.
  14. Shirai Y, Tsukada K, Ohtani T, et al (1995). Hepatic metastasis from carcinoma of the gallbladder. Cancer, 75, 2063-8. https://doi.org/10.1002/1097-0142(19950415)75:8<2063::AID-CNCR2820750806>3.0.CO;2-S
  15. Suzuki S, Yokoi Y, Kurachi K, et al (2004). Appraisal of surgical treatment for pT2 gallbladder carcinomas. World J Surg, 28, 160-5. https://doi.org/10.1007/s00268-003-7080-y

Cited by

  1. Prognostic Implications of SLIT and ROBO1 Expression in Gallbladder Cancer vol.70, pp.2, 2014, https://doi.org/10.1007/s12013-014-9976-6
  2. Surgical treatment for gallbladder cancer – a systematic literature review vol.52, pp.5, 2017, https://doi.org/10.1080/00365521.2017.1284895