Examination of prognostic factors affecting long-term survival of patients with stage 3/4 gallbladder cancer without distant metastasis

Ryota Higuchi, Takehisa Yazawa, Shuichirou Uemura, Yutaro Matsunaga, Takehiro Ota, Tatsuo Araida, Toru Furukawa, Masakazu Yamamoto

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

In advanced gallbladder cancer (GBC) radical resection, if multiple prognostic factors are present, the outcome may be poor; however, the details remain unclear. To investigate the poor prognostic factors affecting long-term surgical outcome, we examined 157 cases of resected stage 3/4 GBC without distant metastasis between 1985 and 2017. Poor prognostic factors for overall survival and treatment outcomes of a number of predictable preoperative poor prognostic factors were evaluated. The surgical mortality was 4.5%. In multivariate analysis, blood loss, poor histology, liver invasion, and ≥4 regional lymph node metastases (LNMs) were independent prognostic factors for poor surgical outcomes; invasion of the left margin or the entire area of the hepatoduodenal ligament and a Clavien–Dindo classification ≥3 were marginal factors. The analysis identified outcomes of patients with factors that could be predicted preoperatively, such as liver invasion ≥5 mm, invasion of the left margin or the entire area of the hepatoduodenal ligament, and ≥4 regional LNMs. Thus, the five-year overall survival was 54% for zero factors, 34% for one factor, and 4% for two factors (p < 0.05). A poor surgical outcome was likely when two or more factors were predicted preoperatively; therefore, new treatment strategies are required for such patients.

Original languageEnglish
Article number2073
Pages (from-to)1-11
Number of pages11
JournalCancers
Volume12
Issue number8
DOIs
Publication statusPublished - 2020 Aug
Externally publishedYes

Keywords

  • Distant metastases
  • Gallbladder cancer
  • Overall survival
  • Prognostic factor
  • Surgical outcome

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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