Long-term results and prognostic factors after surgical treatment for gallbladder cancer
Mehmet Ali Uzun1,2
, Metin Tilki1, Sevcan Alkan Kayaoğlu1, Gülten Çiçek Okuyan1, Zeynep Gamze Kılıçoğlu3, Aylin Gönültaş4
1Clinic of General Surgery, Haydarpaşa Numune Training and Research Hospital, University of Health Sciences, İstanbul, Türkiye
2Clinic of General Surgery, Şişli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, İstanbul, Türkiye
3Clinic of Radiology, Haydarpaşa Numune Training and Research Hospital, University of Health Sciences, İstanbul, Türkiye
4 Clinic of Pathology, Haydarpaşa Numune Training and Research Hospital, University of Health Sciences, İstanbul, Türkiye
Abstract
Objective: Gallbladder cancer is relatively rare and traditionally regarded as having poor prognosis. There is controversy about the effects of clinicopathological features and different surgical techniques on prognosis. The aim of this study was to investigate the effects of clinicopathological characteristics of the patients with surgically treated gallbladder cancer on long-term survival.
Material and Methods: We retrospectively analyzed the database of gallbladder cancer patients treated at our clinic between January 2003 and March 2021.
Results: Of 101 evaluated cases, 37 were inoperable. Twelve patients were determined unresectable based on surgical findings. Resection with curative intent was performed in 52 patients. The one-, three-, five-, and 10-year survival rates were 68.9%, 51.9%, 43.6%, and 43.6%, respectively. Median survival was 36.6 months. On univariate analysis, poor prognostic factors were determined as advanced age; high carbohydrate antigen 19-9 and carcinoembryonic antigen levels; non-incidental diagnosis; intraoperative incidental diagnosis; jaundice; adjacent organ/structure resection; grade 3 tumors; lymphovascular invasion; and high T, N1 or N2, M1, and high AJCC stages. Sex, IVb/V segmentectomy instead of wedge resection, perineural invasion, tumor location, number of resected lymph nodes, and extended lymphadenectomy did not significantly affect overall survival. On multivariate analysis, only high AJCC stages, grade 3 tumors, high carcinoembryonic antigen levels, and advanced age were independent predictors of poor prognosis.
Conclusion: Treatment planning and clinical decision-making for gallbladder cancer requires individualized prognostic assessment along with standard anatomical staging and other confirmed prognostic factors.
Keywords: Biliary tract surgical procedures, gallbladder neoplasm, prognostic factors, survival
Cite this article as: Uzun MA, Tilki M, Kayaoğlu SA, Çiçek Okuyan G, Kılıçoğlu ZG, Gönültaş A. Long-term results and prognostic factors after surgical treatment for gallbladder cancer. Turk J Surg 2022; 38 (4): 334-344.
Approval for the study was obtained from Haydarpaşa Numune Training and Research Hospital Clinical Research Ethics Committee (Protocol number: 2021/65, Approval date: 02.15.2021).
Externally peer-reviewed.
Concept – All of authors; Design – All of authors; Supervision – All of authors; Fundings - MAU; Materials - MAU, AG; Data Collection and/ or Processing – MAU, MT, SAK, AG; Analysis and/or Interpretation – All of authors; Literature Search – All of authors; Writing Manuscript – All of authors; Critical Reviews – All of authors.
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.