Analysis of therapeutic effect of T2a gallbladder cancer whether combined with liver resection or not_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WU Xin ,  HONG Tao , LI Binglu , ZHENG Chaoji , LIU Wei , HE Xiaodong

Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, P. R. China;

Corresponding author：

HONG Tao, Email: hongtaopumch@163.com

Keywords：

gallbladder cancer; T2a stage; surgery; prognosis

DOI：

10.7507/1007-9424.202205005

Video：

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Objective To investigate the effect of combined or non-combined liver resection for T2a gallbladder cancer. Methods According to the established inclusion and exclusion criteria, the patients with T2a gallbladder cancer admitted to Peking Union Medical College Hospital from January 2016 to December 2021 were retrospectively collected, then were assigned into combined with liver resection group and non-combined with liver resection group. The general characteristics, perioperative information, and prognosis of the two groups were compared. Results A total of 58 patients were enrolled in this study, including 23 males and 35 females; aged (64.8±11.1) years. There were 43 cases in the combined with liver resection group and 15 cases in the non-combined with liver resection group. There were no statistic differences in the demographic data, lifestyle, onset symptoms, preoperative combined diseases, and preoperative tumor markers between the two groups (P>0.05). Compared with the combined with liver resection group, the proportion of patients received bile duct resection was higher (P=0.013) and the operation time was shorter (P=0.045) in the non-combined with liver resection group. There were no statistic differences in the other perioperative informations between the two groups (P>0.05). A total of 12 patients had postoperative complications, including 3 cases of grade Ⅰ, 8 cases of grade Ⅱ, and 1 case of grade Ⅲa by Clavien-Dindo classification. All patients improved after treatment and were discharged smoothly. No patient was readmitted within 30 d after discharge. All 58 patients were followed up with a median follow up time of 29 months. During the follow-up period, there were 47 cases (81.0%) of tumor-free survival, 2 cases (3.4%) of survival with tumor, and 9 cases (15.5%) of death. There were no statistic differences in the overall survival and disease-free survival between the two groups by log-rank test (χ²=3.418, P=0.064; χ²=1.543, P=0.214). Conclusion Fromthe results of this study, for T2a gallbladder cancer, liver resection would not result in increased complications or longer hospital stay, but don’t obviously improve prognosis.

Citation： WU Xin, HONG Tao, LI Binglu, ZHENG Chaoji, LIU Wei, HE Xiaodong. Analysis of therapeutic effect of T2a gallbladder cancer whether combined with liver resection or not. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(11): 1458-1462. doi: 10.7507/1007-9424.202205005 Copy

1.	Miranda-Filho A, Piñeros M, Ferreccio C, et al. Gallbladder and extrahepatic bile duct cancers in the Americas: incidence and mortality patterns and trends. Int J Cancer, 2020, 147(4): 978-989.
2.	孙旭恒, 王一钧, 张薇, 等. 中国胆囊癌流行病学特征与诊治及预后分析(附6 159例报告). 中华消化外科杂志, 2022, 21(1): 114-128.
3.	Zhu AX, Pawlik TM, Kooby DA, et al. Gallbladder//Amin MB. AJCC cancer staging manual. 8th ed. New York: Springer, 2017: 303-309.
4.	胆道肿瘤专家委员会. CSCO胆道系统肿瘤诊断治疗专家共识(2019年版). 临床肿瘤学杂志, 2019, 24(9): 828-838.
5.	中华医学会外科学分会胆道外科学组, 中国医师协会外科医师分会胆道外科专业委员会. 胆囊癌诊断和治疗指南(2019版). 中华外科杂志, 2020, 58(4): 243-251.
6.	Lee W, Jeong CY, Jang JY, et al. Do hepatic-sided tumors require more extensive resection than peritoneal-sided tumors in patients with T2 gallbladder cancer? Results of a retrospective multicenter study. Surgery, 2017, 162(3): 515-524.
7.	刘鹏, 张贤彬, 耿智敏, 等. 不同手术方式治疗T1b期胆囊癌效果的多中心研究. 中华外科杂志, 2018, 56(5): 355-359.
8.	Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6 336 patients and results of a survey. Ann Surg, 2004, 240(2): 205-213.
9.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
10.	Cho JK, Lee W, Jang JY, et al. Validation of the oncologic effect of hepatic resection for T2 gallbladder cancer: a retrospective study. World J Surg Oncol, 2019, 17(1): 8. doi: 10.1186/s12957-018-1556-6.
11.	Li G, Kim JH, Jung W, et al. Significance of hepatectomy in patients diagnosed with T2 gallbladder cancer. Surg Laparosc Endosc Percutan Tech, 2020, 30(1): 35-39.
12.	Khan SM, Emile SH, Choudhry MS, et al. Tumor location and concurrent liver resection, impact survival in T2 gallbladder cancer: a meta-analysis of the literature. Updates Surg, 2021, 73(5): 1717-1726.
13.	Kwon W, Kim H, Han Y, et al. Role of tumour location and surgical extent on prognosis in T2 gallbladder cancer: an international multicentre study. Br J Surg, 2020, 107(10): 1334-1343.
14.	Lafaro K, Blakely AM, Melstrom LG, et al. Prognostic impact of tumor location in resected gallbladder cancer: a national cohort analysis. J Surg Oncol, 2020, 122(6): 1084-1093.
15.	滕达, 刘鹏, 耿智敏, 等. T1、T2期胆囊癌手术方式选择. 中华肝脏外科手术学电子杂志, 2021, 10(1): 24-28.
16.	孙培伟, 滕达, 巩鹏. 新分期带来的胆囊癌手术范围合理性的争议. 西安交通大学学报(医学版), 2021, 42(1): 7-10, 58.
17.	王泽宇, 黑振宇, 耿亚军, 等. 基于TNM分期的胆囊癌手术治疗. 中国实用外科杂志, 2021, 41(2): 236-238.
18.	Kim WJ, Lim TW, Park PJ, et al. Clinicopathological differences in T2 gallbladder cancer according to tumor location. Cancer Control, 2020, 27(1): 1073274820915514. doi: 10.1177/1073274820915514.
19.	Chen M, Cao J, Xiang Y, et al. Hepatectomy strategy for T2 gallbladder cancer between segment Ⅳb and Ⅴ resection and wedge resection: a propensity score-matched study. Surgery, 2021, 169(6): 1304-1311.
20.	Nag HH, Nekarakanti PK, Sachan A, et al. Bi-segmentectomy versus wedge hepatic resection in extended cholecystectomy for T2 and T3 gallbladder cancer: a matched case-control study. Ann Hepatobiliary Pancreat Surg, 2021, 25(4): 485-491.

1. Miranda-Filho A, Piñeros M, Ferreccio C, et al. Gallbladder and extrahepatic bile duct cancers in the Americas: incidence and mortality patterns and trends. Int J Cancer, 2020, 147(4): 978-989.
2. 孙旭恒, 王一钧, 张薇, 等. 中国胆囊癌流行病学特征与诊治及预后分析(附6 159例报告). 中华消化外科杂志, 2022, 21(1): 114-128.
3. Zhu AX, Pawlik TM, Kooby DA, et al. Gallbladder//Amin MB. AJCC cancer staging manual. 8th ed. New York: Springer, 2017: 303-309.
4. 胆道肿瘤专家委员会. CSCO胆道系统肿瘤诊断治疗专家共识(2019年版). 临床肿瘤学杂志, 2019, 24(9): 828-838.
5. 中华医学会外科学分会胆道外科学组, 中国医师协会外科医师分会胆道外科专业委员会. 胆囊癌诊断和治疗指南(2019版). 中华外科杂志, 2020, 58(4): 243-251.
6. Lee W, Jeong CY, Jang JY, et al. Do hepatic-sided tumors require more extensive resection than peritoneal-sided tumors in patients with T2 gallbladder cancer? Results of a retrospective multicenter study. Surgery, 2017, 162(3): 515-524.
7. 刘鹏, 张贤彬, 耿智敏, 等. 不同手术方式治疗T1b期胆囊癌效果的多中心研究. 中华外科杂志, 2018, 56(5): 355-359.
8. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6 336 patients and results of a survey. Ann Surg, 2004, 240(2): 205-213.
9. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
10. Cho JK, Lee W, Jang JY, et al. Validation of the oncologic effect of hepatic resection for T2 gallbladder cancer: a retrospective study. World J Surg Oncol, 2019, 17(1): 8. doi: 10.1186/s12957-018-1556-6.
11. Li G, Kim JH, Jung W, et al. Significance of hepatectomy in patients diagnosed with T2 gallbladder cancer. Surg Laparosc Endosc Percutan Tech, 2020, 30(1): 35-39.
12. Khan SM, Emile SH, Choudhry MS, et al. Tumor location and concurrent liver resection, impact survival in T2 gallbladder cancer: a meta-analysis of the literature. Updates Surg, 2021, 73(5): 1717-1726.
13. Kwon W, Kim H, Han Y, et al. Role of tumour location and surgical extent on prognosis in T2 gallbladder cancer: an international multicentre study. Br J Surg, 2020, 107(10): 1334-1343.
14. Lafaro K, Blakely AM, Melstrom LG, et al. Prognostic impact of tumor location in resected gallbladder cancer: a national cohort analysis. J Surg Oncol, 2020, 122(6): 1084-1093.
15. 滕达, 刘鹏, 耿智敏, 等. T1、T2期胆囊癌手术方式选择. 中华肝脏外科手术学电子杂志, 2021, 10(1): 24-28.
16. 孙培伟, 滕达, 巩鹏. 新分期带来的胆囊癌手术范围合理性的争议. 西安交通大学学报(医学版), 2021, 42(1): 7-10, 58.
17. 王泽宇, 黑振宇, 耿亚军, 等. 基于TNM分期的胆囊癌手术治疗. 中国实用外科杂志, 2021, 41(2): 236-238.
18. Kim WJ, Lim TW, Park PJ, et al. Clinicopathological differences in T2 gallbladder cancer according to tumor location. Cancer Control, 2020, 27(1): 1073274820915514. doi: 10.1177/1073274820915514.
19. Chen M, Cao J, Xiang Y, et al. Hepatectomy strategy for T2 gallbladder cancer between segment Ⅳb and Ⅴ resection and wedge resection: a propensity score-matched study. Surgery, 2021, 169(6): 1304-1311.
20. Nag HH, Nekarakanti PK, Sachan A, et al. Bi-segmentectomy versus wedge hepatic resection in extended cholecystectomy for T2 and T3 gallbladder cancer: a matched case-control study. Ann Hepatobiliary Pancreat Surg, 2021, 25(4): 485-491.

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Analysis of therapeutic effect of T2a gallbladder cancer whether combined with liver resection or not

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