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Preoperatively suspected gallbladder cancer improves survival compared with incidental gallbladder cancer in pT3 patients

Muszynska, Carolina LU ; Lundgren, Linda ; Jacobsson, Helene ; Sandström, Per and Andersson, Bodil LU orcid (2024) In Scandinavian Journal of Surgery 113(4). p.314-323
Abstract

Background: The aim was to compare survival for incidental gallbladder cancer (IGBC), respectively, preoperatively suspected gallbladder cancer (GBC), subjected to surgery for different pathological tumour (pT) stages and in different treatment groups in a national cohort. Methods: Data were collected and crosslinked from two national quality registers, SweLiv (2009–2019) and GallRiks (2009–2016). Survival was estimated using Kaplan–Meier analysis. The log-rank test and Cox regression analyses were used to compare groups. Results: In total, 466 IGBC patients, including 225 who only underwent simple cholecystectomy (SC), and 477 GBC patients were included. Most patients were female, with small differences in mean age between groups. In... (More)

Background: The aim was to compare survival for incidental gallbladder cancer (IGBC), respectively, preoperatively suspected gallbladder cancer (GBC), subjected to surgery for different pathological tumour (pT) stages and in different treatment groups in a national cohort. Methods: Data were collected and crosslinked from two national quality registers, SweLiv (2009–2019) and GallRiks (2009–2016). Survival was estimated using Kaplan–Meier analysis. The log-rank test and Cox regression analyses were used to compare groups. Results: In total, 466 IGBC patients, including 225 who only underwent simple cholecystectomy (SC), and 477 GBC patients were included. Most patients were female, with small differences in mean age between groups. In all IGBC patients compared with GBC patients, an improved 5-year overall survival in pT3 GBC undergoing surgery (GBC 13% vs all IGBC 8%, p < 0.001), was seen. GBC was shown to be an independent predictor for improved survival in pT3 patients (hazard ratio (HR): 0.6; 95% confidence interval (CI): 0.4–0.8, p < 0.001). In addition, in GBC with curative reresection compared with IGBC SC and IGBC with curative resection, an improved 5-year overall survival in pT3 GBC was shown (GBC 20% vs all IGBC 10%, p < 0.001). GBC was an independent predictor for improved survival in pT3 patients with curative resection (HR: 0.4; 95% CI: 0.3–0.7, p < 0.001). Conclusions: GBC was shown to be an independent predictor for improved survival in pT3 patients, and patients with GBC may benefit from one-stage resection. It is, therefore, reasonable to recommend that radiological suspicion of malignancy should be evaluated at a liver tumour centre to optimize patient outcomes.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Gallbladder cancer, incidental gallbladder cancer, independent predictor, one-stage resection, overall survival, reresection
in
Scandinavian Journal of Surgery
volume
113
issue
4
pages
314 - 323
publisher
Finnish Surgical Society
external identifiers
  • scopus:85199755141
  • pmid:39066517
ISSN
1457-4969
DOI
10.1177/14574969241263539
language
English
LU publication?
yes
id
ef28d7a8-3efc-4a40-99b5-f9c0a44b3554
date added to LUP
2024-12-02 11:31:38
date last changed
2025-07-01 04:53:29
@article{ef28d7a8-3efc-4a40-99b5-f9c0a44b3554,
  abstract     = {{<p>Background: The aim was to compare survival for incidental gallbladder cancer (IGBC), respectively, preoperatively suspected gallbladder cancer (GBC), subjected to surgery for different pathological tumour (pT) stages and in different treatment groups in a national cohort. Methods: Data were collected and crosslinked from two national quality registers, SweLiv (2009–2019) and GallRiks (2009–2016). Survival was estimated using Kaplan–Meier analysis. The log-rank test and Cox regression analyses were used to compare groups. Results: In total, 466 IGBC patients, including 225 who only underwent simple cholecystectomy (SC), and 477 GBC patients were included. Most patients were female, with small differences in mean age between groups. In all IGBC patients compared with GBC patients, an improved 5-year overall survival in pT3 GBC undergoing surgery (GBC 13% vs all IGBC 8%, p &lt; 0.001), was seen. GBC was shown to be an independent predictor for improved survival in pT3 patients (hazard ratio (HR): 0.6; 95% confidence interval (CI): 0.4–0.8, p &lt; 0.001). In addition, in GBC with curative reresection compared with IGBC SC and IGBC with curative resection, an improved 5-year overall survival in pT3 GBC was shown (GBC 20% vs all IGBC 10%, p &lt; 0.001). GBC was an independent predictor for improved survival in pT3 patients with curative resection (HR: 0.4; 95% CI: 0.3–0.7, p &lt; 0.001). Conclusions: GBC was shown to be an independent predictor for improved survival in pT3 patients, and patients with GBC may benefit from one-stage resection. It is, therefore, reasonable to recommend that radiological suspicion of malignancy should be evaluated at a liver tumour centre to optimize patient outcomes.</p>}},
  author       = {{Muszynska, Carolina and Lundgren, Linda and Jacobsson, Helene and Sandström, Per and Andersson, Bodil}},
  issn         = {{1457-4969}},
  keywords     = {{Gallbladder cancer; incidental gallbladder cancer; independent predictor; one-stage resection; overall survival; reresection}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{314--323}},
  publisher    = {{Finnish Surgical Society}},
  series       = {{Scandinavian Journal of Surgery}},
  title        = {{Preoperatively suspected gallbladder cancer improves survival compared with incidental gallbladder cancer in pT3 patients}},
  url          = {{http://dx.doi.org/10.1177/14574969241263539}},
  doi          = {{10.1177/14574969241263539}},
  volume       = {{113}},
  year         = {{2024}},
}