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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 2/2021

Open Access 01-02-2021 | Gallbladder Cancer | Hepatobiliary Tumors

Extended Resections for Advanced Gallbladder Cancer: Results from a Nationwide Cohort Study

Authors: H. Kuipers, BSc, E. A. J. de Savornin Lohman, MD, M. van Dooren, BSc, A. E. Braat, MD, PhD, F. Daams, MD, PhD, R. van Dam, MD, PhD, J. I. Erdmann, MD, PhD, J. Hagendoorn, MD, PhD, F. J. H. Hoogwater, MD, PhD, B. Groot Koerkamp, MD, PhD, T. M. van Gulik, MD, PhD, P. R. de Reuver, MD, PhD, M. T. de Boer, MD, PhD

Published in: Annals of Surgical Oncology | Issue 2/2021

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Abstract

Background

Extended resections (i.e., major hepatectomy and/or pancreatoduodenectomy) are rarely performed for gallbladder cancer (GBC) because outcomes remain inconclusive. Data regarding extended resections from Western centers are sparse. This Dutch, multicenter cohort study analyzed the outcomes of patients who underwent extended resections for locally advanced GBC.

Methods

Patients with GBC who underwent extended resection with curative intent between January 2000 and September 2018 were identified from the Netherlands Cancer Registry. Extended resection was defined as a major hepatectomy (resection of ≥ 3 liver segments), a pancreatoduodenectomy, or both. Treatment and survival data were obtained. Postoperative morbidity, mortality, survival, and characteristics of short- and long-term survivors were assessed.

Results

The study included 33 patients. For 16 of the patients, R0 resection margins were achieved. Major postoperative complications (Clavien Dindo ≥ 3A) occurred for 19 patients, and 4 patients experienced postoperative mortality within 90 days. Recurrence occurred for 24 patients. The median overall survival (OS) was 12.8 months (95% confidence interval, 6.5–19.0 months). A 2-year survival period was achieved for 10 patients (30%) and a 5-year survival period for 5 patients (15%). Common bile duct, liver, perineural and perivascular invasion and jaundice were associated with reduced survival. All three recurrence-free patients had R0 resection margins and no liver invasion.

Conclusion

The median OS after extended resections for advanced GBC was 12.8 months in this cohort. Although postoperative morbidity and mortality were significant, long-term survival (≥ 2 years) was achieved in a subset of patients. Therefore, GBC requiring major surgery does not preclude long-term survival, and a subgroup of patients benefit from surgery.
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Metadata
Title
Extended Resections for Advanced Gallbladder Cancer: Results from a Nationwide Cohort Study
Authors
H. Kuipers, BSc
E. A. J. de Savornin Lohman, MD
M. van Dooren, BSc
A. E. Braat, MD, PhD
F. Daams, MD, PhD
R. van Dam, MD, PhD
J. I. Erdmann, MD, PhD
J. Hagendoorn, MD, PhD
F. J. H. Hoogwater, MD, PhD
B. Groot Koerkamp, MD, PhD
T. M. van Gulik, MD, PhD
P. R. de Reuver, MD, PhD
M. T. de Boer, MD, PhD
Publication date
01-02-2021
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 2/2021
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-08858-z

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