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Heterogeneity of management practices surrounding operable gallbladder cancer – results of the OMEGA-S international HPB surgical survey

Balakrishnan, A. ; Jah, Asif ; Lesurtel, Mickael ; Andersson, B. LU orcid ; Gibbs, Paul ; Harper, Simon J.F. ; Huguet, Emmanuel L. ; Kosmoliaptis, Vasilis ; Liau, Siong S. and Praseedom, Raaj K. , et al. (2022) In HPB 24(11). p.2006-2012
Abstract
Background: Gallbladder cancer (GBC) is an aggressive, uncommon malignancy, with variation in operative approaches adopted across centres and few large-scale studies to guide practice. We aimed to identify the extent of heterogeneity in GBC internationally to better inform the need for future multicentre studies. Methods: A 34-question online survey was disseminated to members of the European-African Hepatopancreatobiliary Association (EAHPBA), American Hepatopancreatobiliary Association (AHPBA) and Asia–Pacific Hepatopancreatobiliary Association (A-PHPBA) regarding practices around diagnostic workup, operative approach, utilization of neoadjuvant and adjuvant therapies and surveillance strategies. Results: Two hundred and three surgeons... (More)
Background: Gallbladder cancer (GBC) is an aggressive, uncommon malignancy, with variation in operative approaches adopted across centres and few large-scale studies to guide practice. We aimed to identify the extent of heterogeneity in GBC internationally to better inform the need for future multicentre studies. Methods: A 34-question online survey was disseminated to members of the European-African Hepatopancreatobiliary Association (EAHPBA), American Hepatopancreatobiliary Association (AHPBA) and Asia–Pacific Hepatopancreatobiliary Association (A-PHPBA) regarding practices around diagnostic workup, operative approach, utilization of neoadjuvant and adjuvant therapies and surveillance strategies. Results: Two hundred and three surgeons responded from 51 countries. High liver resection volume units (>50 resections/year) organised HPB multidisciplinary team discussion of GBCs more commonly than those with low volumes (p < 0.0001). Management practices exhibited areas of heterogeneity, particularly around operative extent. Contrary to consensus guidelines, anatomical liver resections were favoured over non-anatomical resections for T3 tumours and above, lymphadenectomy extent was lower than recommended, and a minority of respondents still routinely excised the common bile duct or port sites. Conclusion: Our findings suggest some similarities in the management of GBC internationally, but also specific areas of practice which differed from published guidelines. Transcontinental collaborative studies on GBC are necessary to establish evidence-based practice to minimise variation and optimise outcomes. © 2022 International Hepato-Pancreato-Biliary Association Inc. (Less)
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author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
HPB
volume
24
issue
11
pages
7 pages
publisher
Elsevier
external identifiers
  • scopus:85137609551
  • pmid:35922277
ISSN
1365-182X
DOI
10.1016/j.hpb.2022.06.014
language
English
LU publication?
yes
id
5bead6c4-7dfe-45ca-bde3-b69e3c80b4c6
date added to LUP
2022-12-19 16:47:42
date last changed
2023-05-10 14:34:00
@article{5bead6c4-7dfe-45ca-bde3-b69e3c80b4c6,
  abstract     = {{Background: Gallbladder cancer (GBC) is an aggressive, uncommon malignancy, with variation in operative approaches adopted across centres and few large-scale studies to guide practice. We aimed to identify the extent of heterogeneity in GBC internationally to better inform the need for future multicentre studies. Methods: A 34-question online survey was disseminated to members of the European-African Hepatopancreatobiliary Association (EAHPBA), American Hepatopancreatobiliary Association (AHPBA) and Asia–Pacific Hepatopancreatobiliary Association (A-PHPBA) regarding practices around diagnostic workup, operative approach, utilization of neoadjuvant and adjuvant therapies and surveillance strategies. Results: Two hundred and three surgeons responded from 51 countries. High liver resection volume units (&gt;50 resections/year) organised HPB multidisciplinary team discussion of GBCs more commonly than those with low volumes (p &lt; 0.0001). Management practices exhibited areas of heterogeneity, particularly around operative extent. Contrary to consensus guidelines, anatomical liver resections were favoured over non-anatomical resections for T3 tumours and above, lymphadenectomy extent was lower than recommended, and a minority of respondents still routinely excised the common bile duct or port sites. Conclusion: Our findings suggest some similarities in the management of GBC internationally, but also specific areas of practice which differed from published guidelines. Transcontinental collaborative studies on GBC are necessary to establish evidence-based practice to minimise variation and optimise outcomes. © 2022 International Hepato-Pancreato-Biliary Association Inc.}},
  author       = {{Balakrishnan, A. and Jah, Asif and Lesurtel, Mickael and Andersson, B. and Gibbs, Paul and Harper, Simon J.F. and Huguet, Emmanuel L. and Kosmoliaptis, Vasilis and Liau, Siong S. and Praseedom, Raaj K. and Ramia, Jose M. and Branes, Alejandro and Lendoire, Javier and Maithel, Shishir and Serrablo, Alejandro}},
  issn         = {{1365-182X}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{2006--2012}},
  publisher    = {{Elsevier}},
  series       = {{HPB}},
  title        = {{Heterogeneity of management practices surrounding operable gallbladder cancer – results of the OMEGA-S international HPB surgical survey}},
  url          = {{http://dx.doi.org/10.1016/j.hpb.2022.06.014}},
  doi          = {{10.1016/j.hpb.2022.06.014}},
  volume       = {{24}},
  year         = {{2022}},
}