Surgical treatment of left and right gallbladder carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

FENG Feiling , CHENG Qingbao , GAO Qingxiang , LI Bin , YU Yong , YI Bin , LIU Chen ,  JIANG Xiaoqing

Center for Biliary Tract Oncology, Naval military Medical University and Department of Hepatobiliary Surgery, Shanghai-Eastern Hepatobiliary Surgery Hospital, Shanghai 200438, P. R. China;

Corresponding author：

JIANG Xiaoqing, Email: jxq1225@sina.com

Keywords：

gallbladder carcinoma; left half part; right half part; surgical procedures; radical operation; prognosis

DOI：

10.7507/1007-9424.201903002

Video：

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Objective To investigate the prognostic impact of tumor location in gallbladder carcinoma in different sites and evaluate the effect of surgical operation on the median survival time of patients.Methods From 2012 to 2016, 382 patients with gallbladder cancer in the Eastern Hepatobiliary Surgery Hospital were divided into 163 cases of gallbladder duct cancer and 219 cases of gallbladder bottom and body cancer. They were received radical resection, extended radical resection and palliative resection.Results The mean survival time was (19.57+15.63) months in the bottom and body cancer group, (14.62+11.12) months in the cystic duct carcinoma group, and the survival time was significantly different between the two groups (P<0.05). After radical surgery, the mean survival time in the cystic duct carcinoma group and the bottom and body cancer group were (23.82±12.47) months and (30.63±17.81) months, respectively, there was no significant difference between the two groups (P>0.05). The multivariate analysis indicated that tumor location, surgical radical therapy, clinical stage, pathological grade, and pathological classification were all independent risk factors influencing the prognosis of patients (P<0.05). There was no significant difference in median survival time between the two groups (P>0.05).Conclusions The prognosis of patients with cystic duct gallbladder carcinoma is worse than that of patients with the bottom and body cancer of the gallbladder, but the prognosis of the two groups after radical resection is similar. The prognosis of patients with extended radical operation according to the condition is similar to that of routine radical operation. There are some differences in clinical stage, pathological grade and pathological classification between the two groups of gallbladder cancer patients. In addition, the great differences exist in the surgical methods, especially in extended radical operation. Therefore, the treatment of gallbladder cancer in these two locations should be treated differently.

Citation： FENG Feiling, CHENG Qingbao, GAO Qingxiang, LI Bin, YU Yong, YI Bin, LIU Chen, JIANG Xiaoqing. Surgical treatment of left and right gallbladder carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(3): 276-281. doi: 10.7507/1007-9424.201903002 Copy

1.	Hueman MT, Vollmer CM, Pawlik TM. Evolving treatment strategies for gallbladder cancer. Ann Surg Oncol, 2009, 16(8): 2101-2115.
2.	任培土, 傅宏. 不同部位原发性胆囊癌的诊治与预后. 中国中西医结合外科杂志, 2011, 17(6): 594-596.
3.	Yamaguchi K, Chijiiwa K, Saiki S, et al. Retrospective analysis of 70 operations for gallbladder carcinoma. Br J Surg, 1997, 84(2): 200-204.
4.	Amin MB, Edge SB, Greene FL, et al. AJCC Cancer Staging Manual. 8th ed. New York: Springer. 2016.
5.	Yokoyama Y, Nishio H, Ebata T, et al. New classification of cystic duct carcinoma. World J Surg, 2008, 32(4): 621-626.
6.	Sikora SS, Sinsh RK. Surgicat strategies in patients with gallbladder cancer: nihilism to optimism. J Surg Oncol, 2006, 93(8): 670-681.
7.	Farrar DA. Carcinoma of the cystic duct. Br J Surg, 1951, 39(154): 183-185.
8.	段伟宏, 周宁新, 王知非. 不同部位胆囊癌扩大根治术的价值. 中华普通外科杂志, 2011, 9(26): 739-742.
9.	Pujani M1, Makker I, Makker A, et al. Expression of human epidermal growth factor receptor (Her 2/neu) and proliferative marker Ki-67: association with clinicopathological parameters in gallbladder carcinoma. Asian Pac J Cancer Prev, 2016, 17(8): 3903-3909.
10.	Wang L, Dong P, Zhang Y, et al. Prognostic validation of the updated 8th edition Tumor-Node-Metastasis classification by the Union for International Cancer Control: Survival analyses of 307 patients with surgically treated gallbladder carcinoma. Oncol Lett, 2018, 16(4): 4427-4433.
11.	Nitta T, Kataoka J, Ohta M, et al. Surgical strategy for suspected early gallbladder carcinoma including incidental gallbladder carcinoma diagnosed during or after cholecystectomy. Ann Med Surg (Lond), 2018, 33(8): 56-59.
12.	Aldossary MY, Alayed AA, Amr S, et al. Primary squamous cell carcinoma of the gallbladder: Report of a rare neoplasm from the Eastern Province of Saudi Arabia. Int J Surg Case Rep, 2018, 51: 186-189.
13.	冯飞灵, 刘辰, 谭蔚锋, 等. 胆囊癌侵犯胆管导致阻塞性黄疸手术治疗效果分析. 第二军医大学学报, 2010, 31(8): 857-860.
14.	Feng FL, Liu C, Li B, et al. Role of radical resection in patients with gallbladder carcinoma and jaundice. Chin Med J (Engl), 2012, 125(5): 752-756.
15.	Hwang KY, Yoon YI, Hwang S, et al. Survival analysis following resection of AJCC stage Ⅲ gallbladder carcinoma based on different combinations of T and N stages. Korean J Hepatobiliary Pancreat Surg, 2015, 19(1): 11-16.
16.	Utsumi M, Sadamori H, Shinoura S, et al. Risk factors of morbidity and predictors of long-term survival after hepatopancreatoduodenectomy for biliary cancer. Hepatogastroenterology, 2014, 61(136): 2167-2172.
17.	Nanashima A, Nagasaki T, Sumida Y, et al. An experience of hepatopancreatoduodenectomy in patients with hepatobiliary malignancies. Hepatogastroenterology, 2008, 55(86-87): 1691-1694.
18.	Du J, Yang XW, Wen ZJ, et al. Relationship between prognosis and time interval from cholecystectomy to reoperation in postoperative incidental gallbladder carcinoma. Chin Med J (Engl), 2018, 131(20): 2503-2505.
19.	Sakuraoka Y, Suzuki T, Tanaka G, et al. A case of obstructive jaundice due to early carcinoma of the cystic duct protruding into the common bile duct. Int J Surg Case Rep, 2018, 52(10): 28-34.
20.	Bosch DE, Yeh MM, Schmidt RA, et al. Gallbladder carcinoma and epithelial dysplasia: Appropriate sampling for histopathology. Ann Diagn Pathol, 2018, 37(9): 7-11.

1. Hueman MT, Vollmer CM, Pawlik TM. Evolving treatment strategies for gallbladder cancer. Ann Surg Oncol, 2009, 16(8): 2101-2115.
2. 任培土, 傅宏. 不同部位原发性胆囊癌的诊治与预后. 中国中西医结合外科杂志, 2011, 17(6): 594-596.
3. Yamaguchi K, Chijiiwa K, Saiki S, et al. Retrospective analysis of 70 operations for gallbladder carcinoma. Br J Surg, 1997, 84(2): 200-204.
4. Amin MB, Edge SB, Greene FL, et al. AJCC Cancer Staging Manual. 8th ed. New York: Springer. 2016.
5. Yokoyama Y, Nishio H, Ebata T, et al. New classification of cystic duct carcinoma. World J Surg, 2008, 32(4): 621-626.
6. Sikora SS, Sinsh RK. Surgicat strategies in patients with gallbladder cancer: nihilism to optimism. J Surg Oncol, 2006, 93(8): 670-681.
7. Farrar DA. Carcinoma of the cystic duct. Br J Surg, 1951, 39(154): 183-185.
8. 段伟宏, 周宁新, 王知非. 不同部位胆囊癌扩大根治术的价值. 中华普通外科杂志, 2011, 9(26): 739-742.
9. Pujani M1, Makker I, Makker A, et al. Expression of human epidermal growth factor receptor (Her 2/neu) and proliferative marker Ki-67: association with clinicopathological parameters in gallbladder carcinoma. Asian Pac J Cancer Prev, 2016, 17(8): 3903-3909.
10. Wang L, Dong P, Zhang Y, et al. Prognostic validation of the updated 8th edition Tumor-Node-Metastasis classification by the Union for International Cancer Control: Survival analyses of 307 patients with surgically treated gallbladder carcinoma. Oncol Lett, 2018, 16(4): 4427-4433.
11. Nitta T, Kataoka J, Ohta M, et al. Surgical strategy for suspected early gallbladder carcinoma including incidental gallbladder carcinoma diagnosed during or after cholecystectomy. Ann Med Surg (Lond), 2018, 33(8): 56-59.
12. Aldossary MY, Alayed AA, Amr S, et al. Primary squamous cell carcinoma of the gallbladder: Report of a rare neoplasm from the Eastern Province of Saudi Arabia. Int J Surg Case Rep, 2018, 51: 186-189.
13. 冯飞灵, 刘辰, 谭蔚锋, 等. 胆囊癌侵犯胆管导致阻塞性黄疸手术治疗效果分析. 第二军医大学学报, 2010, 31(8): 857-860.
14. Feng FL, Liu C, Li B, et al. Role of radical resection in patients with gallbladder carcinoma and jaundice. Chin Med J (Engl), 2012, 125(5): 752-756.
15. Hwang KY, Yoon YI, Hwang S, et al. Survival analysis following resection of AJCC stage Ⅲ gallbladder carcinoma based on different combinations of T and N stages. Korean J Hepatobiliary Pancreat Surg, 2015, 19(1): 11-16.
16. Utsumi M, Sadamori H, Shinoura S, et al. Risk factors of morbidity and predictors of long-term survival after hepatopancreatoduodenectomy for biliary cancer. Hepatogastroenterology, 2014, 61(136): 2167-2172.
17. Nanashima A, Nagasaki T, Sumida Y, et al. An experience of hepatopancreatoduodenectomy in patients with hepatobiliary malignancies. Hepatogastroenterology, 2008, 55(86-87): 1691-1694.
18. Du J, Yang XW, Wen ZJ, et al. Relationship between prognosis and time interval from cholecystectomy to reoperation in postoperative incidental gallbladder carcinoma. Chin Med J (Engl), 2018, 131(20): 2503-2505.
19. Sakuraoka Y, Suzuki T, Tanaka G, et al. A case of obstructive jaundice due to early carcinoma of the cystic duct protruding into the common bile duct. Int J Surg Case Rep, 2018, 52(10): 28-34.
20. Bosch DE, Yeh MM, Schmidt RA, et al. Gallbladder carcinoma and epithelial dysplasia: Appropriate sampling for histopathology. Ann Diagn Pathol, 2018, 37(9): 7-11.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Surgical treatment of left and right gallbladder carcinoma

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