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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 11/2008

01-11-2008 | Gastrointestinal Oncology

A New Scoring System for Gallbladder Cancer (Aiding Treatment Algorithm): An Analysis of 335 Patients

Authors: Parul J. Shukla, MS, FRCS, Rakesh Neve, MS, Savio G. Barreto, MS, Rohini Hawaldar, BSc, DCM, Mandar S. Nadkarni, MS, DNB, MNAMS, K. M. Mohandas, MD, DNB, Shailesh V. Shrikhande, MS, MD

Published in: Annals of Surgical Oncology | Issue 11/2008

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Abstract

Background

There is currently no preoperative staging/scoring system available for gallbladder cancer. Unfortunately, in gallbladder cancer, patients manifest advanced stages of the disease. There is need for a methodology that can aid accurate preoperative staging and the subsequent treatment algorithm. We thus sought to validate a new scoring system, the Tata Memorial Hospital Staging System (TMHSS), for gallbladder cancer.

Methods

TMHSS is based on the cumulative impact of specific features of computed tomographic scan, presence or absence of jaundice, and serum cancer antigen 19–9 levels. This scoring system was first proposed in 2004. Patients with gallbladder cancer were enrolled onto the testing sample for TMHSS to ascertain its validity. A total of 335 consecutive patients with gallbladder cancer who sought care at the Tata Memorial Hospital between May 1, 2005, and December 31, 2006, were studied. Treatment was suggested on the basis of current existing protocols. Each patient was assigned a TMHSS score, and the treatment decision taken was compared with the algorithm generated for each individual score. Concurrence of the decision taken with the score generated algorithm was tested by the Kendall tau-b test.

Results

Ordinal-by-ordinal analysis of the value of the test was .75, which showed excellent concurrence and a statistically significant P value (P < .0001).

Conclusion

TMHSS provides an excellent correlative treatment plan for patients with gallbladder cancer. It has the potential to reduce unnecessary surgical explorations and to direct patients to the ideal treatment strategy, thereby offering a degree of prognostication.
Literature
1.
Balachandran P, Agarwal S, Krishnanin N, et al. Predictors of long-tern survival in patients with gallbladder cancer. J Gastrointest Surg 2006; 10:848–54.PubMedCrossRef
2.
Foster JM, Hoshi H, Gibbs JF, et al. Gallbladder cancer: defining the indications for primary radical resection and radical re-resection. Ann Surg Oncol 2007; 14:833–40.PubMedCrossRef
3.
Todoroki T, Iwasaki K, Irii K, et al. Resection combined with intraoperative radiotherapy (IORT) for stage IV (TNM) gallbladder carcinoma. World J Surg 1991; 15:357–62.PubMedCrossRef
4.
Pradeep R, Kaushik SP, Sikora SS, et al. Predictors of survival in carcinoma of the gallbladder. Cancer 1995; 76:1145–9.PubMedCrossRef
5.
Hawkins WG, DeMatteo RP, Jarnagin WR, et al. Jaundice predicts advanced disease and early mortality in patients with Gallbladder Cancer. Ann Surg Oncol 2004; 11:310–5.PubMedCrossRef
6.
Wittekind C, Greene FL, Mutter RVP, et al. (2004) TNM staging of gallbladder cancers. In: TNM Atlas. 5th edition. New York: Springer. pp 124–34
7.
Donohue JH, Nagorney DM, Grant CS, et al. Carcinoma of the gallbladder. Does radical resection improve outcome? Arch Surg 1990; 125:237–41.PubMed
8.
Onoyama H, Yamamoto M, Tseng A, et al. Extended cholecystectomy for carcinoma of the gallbladder. World J Surg 1995; 19:758–63.PubMedCrossRef
9.
Bartlett DL, Fong Y, Fortner JG, et al. Long-term results after resection for gallbladder cancer. Ann Surg 1996; 224:639–46.PubMedCrossRef
10.
Shukla PJ, Nadkarni MS, Shrikhande SV. Proposal for a new clinico-biochemical-radiological staging system for gallbladder cancer (abstract). HPB 2004; 6(Suppl 1):97
11.
Child CG III, Turcotte JG. Surgery and portal hypertension. In: Child CG III, eds, Major Problems in Clinical Surgery, Philadelphia: WB Saunders, 1964:11–85.
12.
Oertli D, Herzog U, Tondelli P. Primary carcinoma of the gallbladder: operative experience during a 16-year period. Eur J Surg 1993; 159:415–20.PubMed
13.
Bartlett DL, Fong Y. Tumours of the gallbladder. In: Blumgart LH, Fong Y (eds) Surgery of the Liver and Biliary Tract. 3rd edition. Philadelphia: WB Saunders, 2000:993–1016.
14.
Ritts RE, Nagorney DM, Jacobson DA, et al. Comparison of preoperative serum CA 19-9 levels with results of diagnostic imaging modalities in patients undergoing laparotomy for suspected pancreatic or gallbladder disease. Pancreas 1994; 9:707–16.PubMedCrossRef
15.
Franquet T, Montes M, Ruiz de Azua Y, et al. Primary gallbladder carcinoma: imaging findings in 50 patients with pathologic correlation. Gastrointest Radiol 1991; 16:143–8.PubMedCrossRef
16.
Tsuchiya Y. Early carcinoma of the gallbladder: macroscopic features and US findings. Radiology 1991; 179:171–5.PubMed
17.
Kumar A, Aggarwal S. Carcinoma of the gallbladder: CT findings in 50 cases. Abdom Imaging 1994; 19:304–8.PubMedCrossRef
18.
Rodriguez-Fernandez A, Gomez-Rio M, Medina-Benitez A, et al. Application of modern imaging methods in diagnosis of gallbladder cancer. J Surg Oncol 2006; 93:650–64.PubMedCrossRef
19.
Ohtani T, Shirai Y, Tsukada K, et al. Spread of gallbladder carcinoma: CT evaluation with pathologic correlation. Abdom Imaging 1996; 21:195–220.PubMedCrossRef
20.
Misra S, Chaturvedi A, Misra NC, et al. Carcinoma of the gallbladder. Lancet Oncol 2003; 4:167–76.PubMedCrossRef
21.
Yoshimitsu K, Honda H, Shinozaki K, et al. Helical CT of the local spread of carcinoma of the gallbladder: evaluation according to the TNM system in patients who underwent surgical resection. Am J Roentgenol 2002; 179:423–8.
22.
Kim BS, Ha HK, Lee D, et al. Accuracy of CT in local staging of gallbladder carcinoma. Acta Radiol 2002; 43:71–6.PubMedCrossRef
Metadata
Title
A New Scoring System for Gallbladder Cancer (Aiding Treatment Algorithm): An Analysis of 335 Patients
Authors
Parul J. Shukla, MS, FRCS
Rakesh Neve, MS
Savio G. Barreto, MS
Rohini Hawaldar, BSc, DCM
Mandar S. Nadkarni, MS, DNB, MNAMS
K. M. Mohandas, MD, DNB
Shailesh V. Shrikhande, MS, MD
Publication date
01-11-2008
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 11/2008
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-008-9917-y

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