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Extended Resections for Advanced Gallbladder Cancer: Results from a Nationwide Cohort Study
- Source :
- Annals of Surgical Oncology, Annals of Surgical Oncology, 28(2), 835-843. Springer New York, Annals of Surgical Oncology, 28(2), 835-843. SPRINGER, Annals of Surgical Oncology, 28, 835-843, Annals of Surgical Oncology, 28, 2, pp. 835-843, Annals of Surgical Oncology, 28(2), 835-843. Springer, Cham
- Publication Year :
- 2020
- Publisher :
- Springer International Publishing, 2020.
-
Abstract
- Background Extended resections (i.e., major hepatectomy and/or pancreatoduodenectomy) are rarely performed for gallbladder cancer (GBC) because outcomes remain inconclusive. Data regarding extended resections from Western centers are sparse. This Dutch, multicenter cohort study analyzed the outcomes of patients who underwent extended resections for locally advanced GBC. Methods Patients with GBC who underwent extended resection with curative intent between January 2000 and September 2018 were identified from the Netherlands Cancer Registry. Extended resection was defined as a major hepatectomy (resection of ≥ 3 liver segments), a pancreatoduodenectomy, or both. Treatment and survival data were obtained. Postoperative morbidity, mortality, survival, and characteristics of short- and long-term survivors were assessed. Results The study included 33 patients. For 16 of the patients, R0 resection margins were achieved. Major postoperative complications (Clavien Dindo ≥ 3A) occurred for 19 patients, and 4 patients experienced postoperative mortality within 90 days. Recurrence occurred for 24 patients. The median overall survival (OS) was 12.8 months (95% confidence interval, 6.5–19.0 months). A 2-year survival period was achieved for 10 patients (30%) and a 5-year survival period for 5 patients (15%). Common bile duct, liver, perineural and perivascular invasion and jaundice were associated with reduced survival. All three recurrence-free patients had R0 resection margins and no liver invasion. Conclusion The median OS after extended resections for advanced GBC was 12.8 months in this cohort. Although postoperative morbidity and mortality were significant, long-term survival (≥ 2 years) was achieved in a subset of patients. Therefore, GBC requiring major surgery does not preclude long-term survival, and a subgroup of patients benefit from surgery.
- Subjects :
- medicine.medical_specialty
CARCINOMA
medicine.medical_treatment
INVASION
Cohort Studies
Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14]
SDG 3 - Good Health and Well-being
Epidemiology
medicine
Carcinoma
MANAGEMENT
EPIDEMIOLOGY
Hepatectomy
Humans
RADICAL RESECTION
Gallbladder cancer
Netherlands
business.industry
Jaundice
medicine.disease
Pancreaticoduodenectomy
Cancer registry
Surgery
Survival Rate
PATHOLOGY
Treatment Outcome
Oncology
Hepatobiliary Tumors
Cohort
PANCREATICODUODENECTOMY
SURVIVAL
PATTERNS
Gallbladder Neoplasms
medicine.symptom
Neoplasm Recurrence, Local
business
Cohort study
Subjects
Details
- Language :
- English
- ISSN :
- 15344681 and 10689265
- Volume :
- 28
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Annals of Surgical Oncology
- Accession number :
- edsair.doi.dedup.....f655a38ebf6c37c81e745f7f21c1ca27