Operative management and outcomes of gallbladder cancer in Australia: a multi-institutional, retrospective, observational cohort analysis
- Author(s)
- Santucci, J; Hua, C; Chong, L; Lockie, E; Lim, J; Lim, S; Zhou, W; Bradshaw, L; Melbourne HPB Collaborative;
- Journal Title
- ANZ Journal of Surgery
- Publication Type
- Online publication before print
- Abstract
- BACKGROUND: Data on optimal extent of resection for various stages of gallbladder cancer are lacking. This study aims to evaluate disease-free (DFS) and overall survival (OS) after simple (SC) versus radical cholecystectomy (RC) for gallbladder cancer in the Australian context, and assesses factors associated with post-operative morbidity. METHODS: Multi-centre, retrospective cohort analysis including all gallbladder cancer patients who underwent resection across six Australian institutions between January 2010 and January 2020. RESULTS: Of 63 patients included, 31 underwent SC and 32 had RC. Liver and other organ resection correlated with prolonged median DFS (41.9 vs. 13.1 months, HR 0.492 [95% CI 0.245-0.987], P = 0.042) and OS on univariate analysis of all patients (55.8% survived five years follow-up at study conclusion vs. median 18.4 months, HR 0.66 [95% CI 0.446-0.972], P = 0.036) but failed to demonstrate effect on multivariable analysis (OS HR 0.31 [95% CI 0.09-1.04], P = 0.057). RC was associated with a higher 30-day complication rate (n = 21 [65.6%] vs. n = 15 [48.4%], P = 0.310) compared to SC, although not statistically significant. There was no significant difference in the major morbidity rate (Clavien-Dindo ≥ Grade III) observed after SC (n = 7 [22.6%]) compared with RC (n = 6 [18.7%], P = 0.754). Neoadjuvant therapy was not utilized and adjuvant treatment used infrequently. CONCLUSION: Extended gallbladder cancer resection was associated with prolonged OS and DFS but also considerable post-operative morbidity. Further studies are warranted to determine the optimal extent of surgical resection by stage of gallbladder cancer.
- Keywords
- Gallbladder cancer; Liver resection; Radical cholecystectomy; Simple cholecystectomy; Survival analysis
- Department(s)
- Surgical Oncology
- Publisher's Version
- https://doi.org/10.1111/ans.19300
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- Refer to copyright notice on published article.
Creation Date: 2024-12-19 05:48:11
Last Modified: 2024-12-19 05:48:41