Abstract
ObjectiveThe aim of the study is to evaluate the impact of application of surgical strategies at different cancer stages on the survival of gallbladder cancer (GBC) patients.MethodsThe patients with GBC were divided into 3 groups according to their received surgical strategies: simple resection (full-thickness cholecystectomy for removal of primary tumor site), radical resection (gallbladder bed removal combined with partial hepatectomy), and palliative surgery (treatment at advanced stages). The overall survival (OS) of GBC patients who were received different surgical strategies was compared.ResultsSurvival analysis showed that radical resection had a best OS at clinical stage II, and simple resection had a best OS at tumor clinical stage IV. Cox hazard proportional regression analysis showed that more advanced tumor stages, tumor location of gallbladder body or neck, and CA199 ≥ 27 U/mL were the major risk factors for the OS of GBC.ConclusionsAt tumor stage II, radical resection should be the most effective surgical therapy for GBC. However, the effect of radical resection at advanced stages could be restricted. The utilization of radical resection should be increased at tumor stage II for a better long-term survival outcome.
Highlights
According to the Global Cancer Statistics 2018, gallbladder cancer (GBC) caused an estimated 219,420 new cases and 165,087 new deaths worldwide in the year 2018 [1]
Population and characteristics of the GBC patients There were a total of 1146 cases of diagnosed GBC from 2012 to 2017
Three hundred ninety-three cases were excluded for undergoing no surgery or an unknown surgery, 18 cases were excluded for recurrence of primary GBC, and 20 cases were excluded for suffering with other types of cancer
Summary
According to the Global Cancer Statistics 2018, gallbladder cancer (GBC) caused an estimated 219,420 new cases and 165,087 new deaths worldwide in the year 2018 [1]. The incidence and mortality of GBC is much higher in developing countries or areas, such as India, Valdivia, Chile, South America, Pakistan, Eastern Europe, and China, than that in developed countries [2]. As the most common cancer type of biliary tract cancer, 70% of GBC are incidentally diagnosed after a routine. Guidelines for GBC radical resection vary in different countries [9]. Goetze et al have demonstrated the effective of radical resection for incidental GBC [5]. As an important treatment strategy of GBC, radical resection is underutilized in practice [10, 11].
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