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Prognostic Significance of Tumor Location in T2 Gallbladder Cancer: A Korea Tumor Registry System Biliary Pancreas (KOTUS-BP) Database Analysis

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Author(s)
Seung Eun LeeYoo Shin ChoiYong Hoon KimJin Seok HeoChi-Young JeongWoo Jung LeeHyung Il SeoYoo-Seok YoonJin-Young Jang
Keimyung Author(s)
Kim, Yong Hoon
Department
Dept. of Surgery (외과학)
Journal Title
Journal of clinical medicine
Issued Date
2020
Volume
9
Issue
10
Keyword
gallbladdercarcinomaperitonealhepaticprognosis
Abstract
Background:
T2 gallbladder cancer (GBC) is subdivided into T2a and T2b by the American Joint Committee on Cancer (AJCC) 8th edition. However; there is a lack of evidence for the prognostic significance of tumor location and validation with large-scale studies is needed. The aims of this study were to investigate the clinical features and clinical outcomes of T2 GBC according to tumor location and determine the prognostic significance of tumor location and an appropriate surgical strategy.

Methods:
Between 2000 and 2014 the Korea Tumor Registry System Biliary Pancreas (KOTUS-BP) database was used to identify and enroll a total 707 patients with pathologically diagnosed T2 GBC who underwent curative resection. Clinicopathological findings and long-term follow-up results were analyzed.

Results:
The incidence of lymph node metastasis in T2b was significantly higher than that of T2a tumors (37.9% vs. 29.5%, p = 0.032). The 5-year disease-specific survival of T2a was better than that of T2b tumors (74.8% vs. 65.4%, p = 0.019). There was no significant survival difference in T2a between extended cholecystectomy and simple cholecystectomy with lymph node dissection (81.8% vs. 73.7%, p = 0.361). However; there was a better survival trend for T2b tumor after extended cholecystectomy (71.7% vs. 59.3%, p = 0.057). Adjuvant chemotherapy was associated with improved survival for patients with lymph node metastasis in T2a (72.1% vs. 56.9; p = 0.022) and in T2b (68.2 vs. 48.5; p < 0.001). Multivariate analysis revealed that lymph node metastasis was the only significant poor prognostic factor (Hazard ratio 3.222; 95% confidential interval 1.960-4.489; p < 0.001).

Conclusions:
For T2 GBC; tumor location was not an independent prognostic factor. Lymph node metastasis was a significant poor prognostic factor and adjuvant chemotherapy should be considered for the patients with lymph node metastasis.
Keimyung Author(s)(Kor)
김용훈
Publisher
School of Medicine (의과대학)
Citation
Seung Eun Lee et al. (2020). Prognostic Significance of Tumor Location in T2 Gallbladder Cancer: A Korea Tumor Registry System Biliary Pancreas (KOTUS-BP) Database Analysis. Journal of clinical medicine, 9(10), 3268–3277. doi: 10.3390/jcm9103268
Type
Article
ISSN
2077-0383
Source
https://www.mdpi.com/2077-0383/9/10/3268
DOI
10.3390/jcm9103268
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43151
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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