Gallbladder carcinoma outcomes in an Australian tertiary referral hospital
| Autor: | Elise A. J. de Savornin Lohman, Jaswinder S. Samra, Marianne F T Wietsma, Juliana Andrici, Nazim Bhimani, Philip R. de Reuver, Anthony J. Gill, Thomas J. Hugh, Charles Molloy |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Tertiary referral hospital Tertiary Care Centers 03 medical and health sciences Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] 0302 clinical medicine Median follow-up Adjuvant therapy Carcinoma Medicine Humans Cholecystectomy Stage (cooking) Gallbladder cancer Neoplasm Staging Retrospective Studies business.industry General surgery Gallbladder Australia General Medicine medicine.disease medicine.anatomical_structure 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Surgery Gallbladder Neoplasms business |
| Zdroj: | Anz Journal of Surgery, 91, 603-608 Anz Journal of Surgery, 91, 4, pp. 603-608 |
| ISSN: | 1445-1433 |
| Popis: | Item does not contain fulltext BACKGROUND: This study aimed to examine the presentation, treatment, and long-term outcomes of patients with gallbladder carcinoma (GBC) managed in a surgical unit of an Australian tertiary referral hospital of a 19-year period. METHODS: A retrospective review of prospectively collected data of patients with GBC managed in the Royal North Shore Upper GI Surgical department from October 1999 to March 2018. RESULTS: A total of 104 patients with GBC were identified: 36 patients underwent palliative treatment, 61 patients with gallbladder adenocarcinoma underwent resection with curative intent. Seven patients were excluded. 'Simple cholecystectomy' was undertaken in eight patients, 'standard radical cholecystectomy' in 37 and 'extended radical resection' in 16. The median survival in these patients was 35 months (95% confidence interval (CI) 21.29-55.10), with a median follow up of 60 months (95% CI 38.18-78.39). This compares with an overall median survival of only 4.00 months (95% CI 2.79-6.24) in patients who did not undergo a potentially curative resection. Independent predictors of poor long-term survival included an elevated preoperative serum tumour marker, advanced tumour stage (T3/T4) or node positive disease (N1/N2). CONCLUSION: The biology and stage of GBC at presentation are major factors in determining patient outcome. There is a need for better pre- and post-operative predictors to improve risk stratification, and these are likely to be in the form of molecular markers. Although the focus of surgery should be to ensure an R0 resection, patients with advanced stage disease need to be carefully selected for surgical intervention, and ideally should be managed by a multidisciplinary team in a specialist centre. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text