Tumor location is a strong predictor of tumor progression and survival in T2 gallbladder cancer: an international multicenter study

Junichi Shindoh, Xabier de Aretxabala, Thomas A. Aloia, Juan C arlos Roa, Ivan Roa, Giuseppe Zimmitti, Milind Javle, Claudius Conrad, Dipen M. Maru, Taku Aoki, Luca Vigano, Dario Ribero, Norihiro Kokudo, Lorenzo Capussotti, Jean Nicolas Vauthey

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To determine the prognostic impact of tumor location in gallbladder cancer.

BACKGROUND: Depth of tumor is a strong predictor of survival after curative resection of gallbladder cancer. However, the gallbladder has a unique anatomical relationship with the liver, and the clinical significance of tumor location remains unclear.

METHODS: For 437 patients with gallbladder cancer who underwent resection at 4 international institutions, clinicopathologic characteristics and their association with survival were analyzed. Tumor location was defined as "hepatic side" or "peritoneal side," and the prognostic significance of tumor location was evaluated.

RESULTS: Among the 252 patients with T2 disease, patients with tumors on the hepatic side (T2h, n = 99) had higher rates of vascular invasion, neural invasion, and nodal metastasis than patients with tumors on the peritoneal side (T2p, n = 153) (51% vs 19%, 33% vs 8%, and 40% vs 17%, respectively; P <0.01 for all). After a median follow-up of 58.9 months, 3-year and 5-year survival rates were 52.1% and 42.6%, respectively, for T2h tumors and 73.7% and 64.7%, respectively, for T2p tumors (P = 0.0006). No such differences were observed in T1 or T3 tumors. Multivariate analysis confirmed the independent association of hepatic-side location with survival in T2 tumors (hazard ratio, 2.7; 95% confidence interval, 1.7-4.2; P <0.001). This subclassification of T2 tumors predicted recurrence in the liver (23% vs 3%; P = 0.003) and distant lymph nodes (16% vs 3%; P = 0.019) even after radical resection.

CONCLUSIONS: After curative resection of T2 gallbladder cancer, tumor location predicts the pattern of recurrence and survival.

Original languageEnglish
Pages (from-to)733-739
Number of pages7
JournalAnnals of Surgery
Volume261
Issue number4
DOIs
Publication statusPublished - Apr 1 2015

ASJC Scopus subject areas

  • Medicine(all)

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    Shindoh, J., de Aretxabala, X., Aloia, T. A., Roa, J. C. A., Roa, I., Zimmitti, G., Javle, M., Conrad, C., Maru, D. M., Aoki, T., Vigano, L., Ribero, D., Kokudo, N., Capussotti, L., & Vauthey, J. N. (2015). Tumor location is a strong predictor of tumor progression and survival in T2 gallbladder cancer: an international multicenter study. Annals of Surgery, 261(4), 733-739. https://doi.org/10.1097/SLA.0000000000000728