11 results on '"Muszynska, C."'
Search Results
2. Management of incidental gallbladder cancer in a national cohort
- Author
-
Lundgren, L., Muszynska, C., Ros, Axel, Persson, G., Gimm, O., Andersson, B., Sandström, P., Lundgren, L., Muszynska, C., Ros, Axel, Persson, G., Gimm, O., Andersson, B., and Sandström, P.
- Abstract
Background: Incidental gallbladder cancer is a rare event, and its prognosis is largely affected by the tumour stage and treatment. The aim of this study was to analyse the management, treatment and survival of patients with incidental gallbladder cancer in a national cohort over a decade. Methods: Patients were identified through the Swedish Registry of Gallstone Surgery (GallRiks). Data were cross-linked to the national registry for liver surgery (SweLiv) and the Cancer Registry. Medical records were collected if registry data were missing. Survival was measured as disease-specific survival. The study was divided into two intervals (2007–2011 and 2012–2016) to evaluate changes over time. Results: In total, 249 patients were identified with incidental gallbladder cancer, of whom 92 (36·9 per cent) underwent re-resection with curative intent. For patients with pT2 and pT3 disease, median disease-specific survival improved after re-resection (12·4 versus 44·1 months for pT2, and 9·7 versus 23·0 months for pT3). Residual disease was present in 53 per cent of patients with pT2 tumours who underwent re-resection; these patients had a median disease-specific survival of 32·2 months, whereas the median was not reached in patients without residual disease. Median survival increased by 11 months for all patients between the early and late periods (P = 0·030). Conclusion: Re-resection of pT2 and pT3 incidental gallbladder cancer was associated with improved survival, but survival was impaired when residual disease was present. A higher re-resection rate and more R0 resections in the later time period may have been associated with improved survival.
- Published
- 2019
- Full Text
- View/download PDF
3. Management of incidental gallbladder cancer in a national cohort
- Author
-
Lundgren, L, primary, Muszynska, C, additional, Ros, A, additional, Persson, G, additional, Gimm, O, additional, Andersson, B, additional, and Sandström, P, additional
- Published
- 2019
- Full Text
- View/download PDF
4. A risk score model to predict incidental gallbladder cancer in patients scheduled for cholecystectomy
- Author
-
Andersson, B., primary, Muszynska, C., additional, Lundgren, L., additional, Lindell, G., additional, Andersson, R., additional, Nilsson, J., additional, and Sandström, P., additional
- Published
- 2019
- Full Text
- View/download PDF
5. Early discharge after open liver surgery: a unique enhanced recovery programme.
- Author
-
Sanjeevi, S., Unosson, J., Reda, S., Muszynska, C., Fruhling, P., Brandt, F., Zarantonello, L., Isaksson, B., Karlson, B.M., Månsson, C., Sternby, H., and Urdzik, J.
- Published
- 2024
- Full Text
- View/download PDF
6. The role of neoadjuvant chemotherapy in patients with synchronous colorectal liver metastases.
- Author
-
Sternby, H., Brandt, F., Unosson, J., Månsson, C., Sanjeevi, S., Zarantonello, L., Muszynska, C., Reda, S., Tingstedt, B., and Frühling, P.
- Published
- 2024
- Full Text
- View/download PDF
7. Preoperatively suspected gallbladder cancer improves survival compared with incidental gallbladder cancer in pT3 patients.
- Author
-
Muszynska C, Lundgren L, Jacobsson H, Sandström P, and Andersson B
- Abstract
Background: The aim was to compare survival for incidental gallbladder cancer (IGBC), respectively, preoperatively suspected gallbladder cancer (GBC), subjected to surgery for different pathological tumour (pT) stages and in different treatment groups in a national cohort., Methods: Data were collected and crosslinked from two national quality registers, SweLiv (2009-2019) and GallRiks (2009-2016). Survival was estimated using Kaplan-Meier analysis. The log-rank test and Cox regression analyses were used to compare groups., Results: In total, 466 IGBC patients, including 225 who only underwent simple cholecystectomy (SC), and 477 GBC patients were included. Most patients were female, with small differences in mean age between groups. In all IGBC patients compared with GBC patients, an improved 5-year overall survival in pT3 GBC undergoing surgery (GBC 13% vs all IGBC 8%, p < 0.001), was seen. GBC was shown to be an independent predictor for improved survival in pT3 patients (hazard ratio (HR): 0.6; 95% confidence interval (CI): 0.4-0.8, p < 0.001). In addition, in GBC with curative reresection compared with IGBC SC and IGBC with curative resection, an improved 5-year overall survival in pT3 GBC was shown (GBC 20% vs all IGBC 10%, p < 0.001). GBC was an independent predictor for improved survival in pT3 patients with curative resection (HR: 0.4; 95% CI: 0.3-0.7, p < 0.001)., Conclusions: GBC was shown to be an independent predictor for improved survival in pT3 patients, and patients with GBC may benefit from one-stage resection. It is, therefore, reasonable to recommend that radiological suspicion of malignancy should be evaluated at a liver tumour centre to optimize patient outcomes., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.
- Published
- 2024
- Full Text
- View/download PDF
8. A risk score model to predict incidental gallbladder cancer in patients scheduled for cholecystectomy.
- Author
-
Muszynska C, Nilsson J, Lundgren L, Lindell G, Andersson R, Sandström P, and Andersson B
- Subjects
- Aged, Cohort Studies, Female, Forecasting, Gallbladder Neoplasms epidemiology, Humans, Male, Middle Aged, Risk Assessment, Cholecystectomy, Cholecystitis surgery, Gallbladder Neoplasms diagnosis, Incidental Findings, Models, Statistical
- Abstract
Background: Gallbladder cancer (GBC) has a poor prognosis. The aim was to develop and validate a preoperative risk score for incidental gallbladder cancer (IGBC) in patients scheduled for cholecystectomy., Methods: Data registered in the nationwide Swedish Registry for Gallstone Surgery (GallRiks) was analyzed, including the derivation cohort (n = 28915, 2007-2014) and the validation cohort (n = 7851, 2014-2016). An additive risk score model based on odds ratio was created., Results: The scoring model to predict IGBC includes age, female gender, previous cholecystitis, and either jaundice or acute cholecystitis. The calibration by HL test and discrimination by AUROC was 8.27 (P = 0.291) and 0.76 in the derivation cohort (214 IGBC) and 14.28 (P = 0.027) and 0.79 in the validation cohort (35 IGBC). The scoring system was applied to three risk-groups, based on the risk of having IGBC, eg. the high-risk group (>8 points) included 7878 patients, with 154 observed and 148 expected IGBC cases., Conclusion: We present the first risk score model to predict IGBC. The model estimates the expected risk for the individual patient and may help to optimize treatment strategies., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2020
- Full Text
- View/download PDF
9. Incidental metastases and lymphoma of the gallbladder - an analysis of ten rare cases identified from a large national database.
- Author
-
Muszynska C, Lundgren L, Andersson R, Søland T, Lindell G, Sandström P, and Andersson B
- Subjects
- Adult, Aged, Female, Gallbladder Neoplasms mortality, Gallbladder Neoplasms secondary, Humans, Kaplan-Meier Estimate, Lymphoma mortality, Lymphoma pathology, Male, Middle Aged, Preoperative Period, Registries, Retrospective Studies, Risk Factors, Sweden, Cholecystectomy, Gallbladder surgery, Gallbladder Neoplasms diagnosis, Incidental Findings, Lymphoma diagnosis
- Abstract
Background: The aim was to identify and characterize rare malignancies of the gallbladder, incidentally found at cholecystectomy, and describe the diagnostic work-up, treatment and outcome. Methods: Data from cholecystectomies during 2007-2014 registered in the Swedish Register for Gallstone Surgery (GallRiks) were analyzed for incidental cancer. For completion of the pathology report, data were linked with the Swedish Registry for Cancer in the liver and biliary tract (SweLiv) and/or the Swedish Cancer Registry. Results: From 36,355 patients that underwent cholecystectomy on a benign indication 215 cases of incidental gallbladder cancer (IGBC) were identified. In total seven patients with metastases to the gallbladder from different primary tumors (breast cancer, malignant melanoma, gastric cancer, renal cell carcinoma, upper gastrointestinal cancer, colon cancer and pancreatic cancer) and three patients with lymphoma involvement of the gallbladder were found. Most patients were female with no difference between the groups (8/10 versus 171/215). The median age for the metastasis and lymphoma (MOL) group was equal to the IGBC group, 70 (64-72) years versus 70 (63-78) years. All patients in the MOL group underwent preoperative imaging with ultrasound or computed tomography, on which no metastases were identified. In only two patients a tumor was seen by the surgeon during the perioperative examination of the gallbladder. The median survival was 5.8 months for MOL patients and 23 months for IGBC patients. Conclusion: Metastases and lymphoma of the gallbladder are rare. Traditional imaging methods prior to cholecystectomy may miss gallbladder malignancies. A liberal approach of histopathological analysis of the gallbladder should be applied.
- Published
- 2019
- Full Text
- View/download PDF
10. Are Incidental Gallbladder Cancers Missed with a Selective Approach of Gallbladder Histology at Cholecystectomy?
- Author
-
Lundgren L, Muszynska C, Ros A, Persson G, Gimm O, Valter L, Andersson B, and Sandström P
- Subjects
- Adult, Aged, Female, Gallbladder Neoplasms pathology, Hospitals, Humans, Male, Middle Aged, Preoperative Period, Prospective Studies, Registries, Reproducibility of Results, Risk Factors, Sweden, Cholecystectomy, Cholecystitis surgery, Gallbladder Neoplasms diagnosis, Incidental Findings
- Abstract
Background: Incidental gallbladder cancer (IGBC) is an unexpected finding when a cholecystectomy is performed upon a benign indication, and the use of routine or selective histological analysis of gallbladder specimen is still debated. The aim of this study was to investigate whether the proportion of submitted gallbladder specimens for pathological investigation influences the proportion of IGBC found, and what possible factors preoperatively or perioperatively could influence the selection process., Methods: All cholecystectomies between January 2007 and September 2014 registered in the Swedish Registry of Gallstone Surgery and ERCP (GallRiks) were included. Proportion of histological analysis was divided into four subgroups (0-25%, >25-50%, >50-75%, >75-100%)., Results: A total of 81,349 cholecystectomies were registered, and 36,010 (44.3%) gallbladder specimens were sent for histological analysis. A total of 213 cases of IGBC were discovered, which constituted 0.26% of all cholecystectomies performed and 0.59% of the number of gallbladder specimens sent for histological analysis. Hospitals submitting >75-100% of the gallbladder specimens had significantly more IGBC/1000 cholecystectomies performed (p = 0.003). Hospitals with the most selective approach had a significantly higher proportion of IGBC/1000 gallbladders that were sent for histological analysis (p < 0.001). Factors such as higher age (p < 0.001), female gender (p = 0.048) and macroscopic cholecystitis (p < 0.001) were more common in gallbladder specimens from hospitals that had a selective approach to histological analysis., Conclusion: A routine approach to histological analysis in cholecystectomies with a benign indication for surgery can uncover a higher proportion of IGBC cases. When a selective approach is used, risk factors should be taken into account.
- Published
- 2018
- Full Text
- View/download PDF
11. Predictors of incidental gallbladder cancer in patients undergoing cholecystectomy for benign gallbladder disease: Results from a population-based gallstone surgery registry.
- Author
-
Muszynska C, Lundgren L, Lindell G, Andersson R, Nilsson J, Sandström P, and Andersson B
- Subjects
- Adult, Aged, Female, Gallbladder Neoplasms surgery, Gallstones pathology, Humans, Logistic Models, Male, Middle Aged, Registries, Risk Factors, Sweden, Cholecystectomy, Gallbladder Neoplasms diagnosis, Gallstones surgery, Incidental Findings
- Abstract
Background: Gallbladder cancer is a rare neoplasm with a poor prognosis. Early diagnosis and correct treatment strategy is important. The aim of this study was to identify predictors for incidental gallbladder cancer., Methods: Data from cholecystectomies registered in the nationwide Swedish Register for Gallstone Surgery between 2007 and 2014 were analyzed for incidental gallbladder cancer. Exclusion criteria were patients with a gallbladder not sent for histopathology, preoperative suspicion of polyps/gallbladder cancer, and indication for operation for other reasons than gallstone disease. Predictive factors for incidental gallbladder cancer were identified using multivariable logistic regression., Results: A total of 86,154 procedures were registered in the Swedish Register for Gallstone Surgery. Of these, 36,355 patients were included in the analysis, and 215 of the included patients had incidental gallbladder cancer (0.59%). Mean age was 70 ± 11 years for index cases and 54 ± 16 years for the control group, and 80% of cases and 60% of controls were female. Predictors for incidental gallbladder cancer were older age (odds ratio = 1.08; P < .001), female sex (odds ratio = 3.58; P < .001), previous cholecystitis (odds ratio = 1.37; P = .045), and the combination of acute cholecystitis without jaundice (odds ratio = 1.39; P = .041) and jaundice without acute cholecystitis (odds ratio = 2.02; P = .009). A preoperative risk model including these factors gave an area under receiver operating characteristic curve of 0.82. By adding macroscopic evaluation of the gallbladder by the surgeon, the area under receiver operating characteristic curve increased to 0.87. Intraoperatively suspected gallbladder cancer was confirmed as cancer in 31% of the cases., Conclusion: Incidental gallbladder cancer is more likely to be diagnosed in older patients, women, and after previous cholecystitis. Jaundice and acute cholecystitis were also shown to be important risk factors. Intraoperative inspection of the gallbladder improved the risk model., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2017
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.