Faculty Collaboration Database

Key factors influencing prognosis in relation to gallbladder cancer. Dig Dis Sci 2013 Sep;58(9):2455-62

Date

05/23/2013

Pubmed ID

23695876

DOI

10.1007/s10620-013-2713-y

Scopus ID

2-s2.0-84884205983 (requires institutional sign-in at Scopus site)   27 Citations

Abstract

INTRODUCTION: The 5-year survival of patients with gallbladder cancer remains low. However, patients can be stratified into prognostic categories based on established factors such as T, N, and R status. New concepts regarding prognostic significance of lymph node disease, the importance of residual gallbladder fossa disease, and the gravity of presentation with jaundice are reviewed. In addition, a number of new prognostic factors proposed in recent years are considered.

METHODS: PubMed was searched for "gallbladder cancer" with builder "date-completion" 2008 to present. A total of 1,490 articles were screened from which 168 were retrieved. From this, 40 articles specifically related to prognosis form the basis for this review.

DISCUSSION: Key factors of prognostic significance remain T and N stage and R0 resection. Residual disease either in the gallbladder fossa, lymph nodes, or cystic duct margin dictates hepatectomy, lymphadenectomy and bile duct resection, respectively. Adequate lymphadenectomy requires removal of six nodes, and hepatectomy must be sufficient to achieve R0. Subtleties regarding lymph node ratio, significance of pathological features such as dedifferentiation, and budding may hold value for stratifying patients with early stage disease, but require further investigation.

Author List

Pilgrim CH, Groeschl RT, Turaga KK, Gamblin TC

Author

Thomas Clark Gamblin MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Bile Ducts
Gallbladder Neoplasms
Humans
Jaundice
Lymphatic Metastasis
Prognosis
Reoperation