Survival after extended resections for gallbladder cancer

Area of Science:

• Surgical Oncology
• Gastrointestinal Surgery
• Oncology

Background:

• Locally advanced gallbladder cancer (GBC) presents a poor prognosis with limited survival.
• Extended resections (ER) are sometimes considered for GBC, but outcomes remain unclear.
• This study evaluates the results of ER in patients with locally advanced GBC.

Purpose of the Study:

• To assess the outcomes of extended resections in locally advanced gallbladder cancer.
• To determine the feasibility and efficacy of various ER procedures for GBC.
• To identify factors influencing survival after ER for GBC.

Main Methods:

• A retrospective review of 19 patients who underwent ER for GBC between 2011 and 2020.
• ER definitions included major hepatectomy, pancreaticoduodenectomy (PD) with or without minor hepatectomy, major hepatectomy with PD (HPD), and vascular resection.
• Outcomes assessed included 30-day morbidity, mortality, and 2-year overall survival (OS).

Main Results:

• Negative margins were achieved in 73.6% of patients.
• 30-day mortality varied by procedure type, with major HPD and vascular resection showing higher rates.
• Long-term survival was significantly better in patients without preoperative jaundice (median OS 13.7 months vs. 4.1 months).
• Patients undergoing major hepatectomy alone or minor HPD had better median OS (11.3 months) compared to major HPD or vascular resection (1.4 months).

Conclusions:

• Extended resection in selected GBC patients can lead to acceptable survival.
• Major hepatectomy alone or a minor hepatectomy with pancreaticoduodenectomy (HPD) are associated with better outcomes.
• Preoperative jaundice and extensive procedures like major HPD or vascular resection are associated with poorer survival.