The significance of anatomic tumor location in gallbladder cancer.
J Surg Oncol
; 123(4): 932-938, 2021 Mar.
Article
em En
| MEDLINE
| ID: mdl-33368336
ABSTRACT
BACKGROUND AND OBJECTIVES:
Current management guidelines recognize the impact of hepatic versus peritoneal sided gallbladder cancers (GBC) on survival. However, no data exist regarding the significance of anatomic tumor location within the gallbladder.METHODS:
We retrospectively analyzed all GBC that underwent surgical resection with curative intent in our health system from 2007 to 2017. We evaluated the effect of anatomic pathologic tumor location (fundus/body, neck, and multifocal) on clinicopathologic, perioperative, and oncologic outcomes.RESULTS:
About 97 patients met criteria; 63% fundus/body, 22% multifocal, and 15% neck. Compared with fundus/body, neck tumors more frequently presented with preoperative jaundice (53% vs. 13%, p < .001), were smaller (20 mm vs. 30 mm, p = .068) and had significantly more biliary tree invasion (33% vs. 13%, p = .030) on histopathology. Although tumor characteristics (pTNM stage, liver invasion, lymphovascular invasion, prognostic nutritional index, and grade) were similar, neck tumors had significantly higher rates of R0 resection (53% vs. 11%, p < .001). Rates of adjuvant therapy were similar. Median PFS was similar between cohorts (p = .356). However, median overall survival (OS) was significantly shorter in neck (21 months) than fundus/body tumors (NR > 109 months), p = .015.CONCLUSIONS:
Neck tumors were rare, small and more likely to result in jaundice secondary to biliary tree invasion. Despite higher R0 resection rates, these tumors had significantly worse OS.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
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Procedimentos Cirúrgicos do Sistema Biliar
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Carcinoma in Situ
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Neoplasias da Vesícula Biliar
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Hepatectomia
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Icterícia
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article