Gallbladder carcinoma outcomes in an Australian tertiary referral hospital

被引:4
|
作者
Wietsma, Marianne F. T. [1 ]
Molloy, Charles [2 ]
Bhimani, Nazim [2 ]
de Savornin Lohman, Elise A. J. [1 ]
Gill, Anthony J. [3 ,4 ]
Andrici, Juliana [3 ]
Samra, Jaswinder [2 ,4 ]
de Reuver, Philip R. [1 ]
Hugh, Thomas J. [2 ,4 ]
机构
[1] Radboud Univ Nijmegen Med Ctr, Dept Surg, Nijmegen, Netherlands
[2] Royal North Shore Hosp, Dept Upper Gastrointestinal Surg, Sydney, NSW, Australia
[3] Royal North Shore Hosp, Kolling Inst Med Res, Canc Diag & Pathol Grp, Sydney, NSW, Australia
[4] Univ Sydney, Northern Clin Sch, Sydney, NSW, Australia
关键词
adjuvant therapy; cholecystectomy; gallbladder cancer; radical resection; surgery; survival;
D O I
10.1111/ans.16663
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background This study aimed to examine the presentation, treatment, and long-term outcomes of patients with gallbladder carcinoma (GBC) managed in a surgical unit of an Australian tertiary referral hospital of a 19-year period. Methods A retrospective review of prospectively collected data of patients with GBC managed in the Royal North Shore Upper GI Surgical department from October 1999 to March 2018. Results A total of 104 patients with GBC were identified: 36 patients underwent palliative treatment, 61 patients with gallbladder adenocarcinoma underwent resection with curative intent. Seven patients were excluded. 'Simple cholecystectomy' was undertaken in eight patients, 'standard radical cholecystectomy' in 37 and 'extended radical resection' in 16. The median survival in these patients was 35 months (95% confidence interval (CI) 21.29-55.10), with a median follow up of 60 months (95% CI 38.18-78.39). This compares with an overall median survival of only 4.00 months (95% CI 2.79-6.24) in patients who did not undergo a potentially curative resection. Independent predictors of poor long-term survival included an elevated preoperative serum tumour marker, advanced tumour stage (T3/T4) or node positive disease (N1/N2). Conclusion The biology and stage of GBC at presentation are major factors in determining patient outcome. There is a need for better pre- and post-operative predictors to improve risk stratification, and these are likely to be in the form of molecular markers. Although the focus of surgery should be to ensure an R0 resection, patients with advanced stage disease need to be carefully selected for surgical intervention, and ideally should be managed by a multidisciplinary team in a specialist centre.
引用
收藏
页码:603 / 608
页数:6
相关论文
共 50 条
  • [1] Audit of middle-ear surgery outcomes in a tertiary referral Australian teaching hospital
    Shah, S.
    Ahmadzada, S.
    Hitos, K.
    da Cruz, M.
    [J]. JOURNAL OF LARYNGOLOGY AND OTOLOGY, 2023, 137 (09): : 1010 - 1016
  • [2] Health Care Costs And Outcomes For Patients Undergoing Tracheostomy In An Australian Tertiary Level Referral Hospital
    Bihari, S.
    Prakash, S.
    Hakendorf, P.
    Horwood, C. M.
    Tarasenko, S.
    Holt, A. W.
    Ratcliffe, J.
    Bersten, A. D.
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2017, 195
  • [3] Pericardiocentesis over 3 years at a tertiary referral Australian hospital
    Ramachandran, J.
    Pender, P.
    Assad, J.
    Wang, A.
    Faour, A.
    Leung, D.
    Rajaratnam, R.
    Mussap, C.
    Juergens, C.
    Lo, S.
    [J]. EUROPEAN HEART JOURNAL, 2022, 43
  • [4] A review of carcinoma of the stomach at a tertiary care referral hospital
    Walker, MJ
    [J]. AMERICAN JOURNAL OF SURGERY, 1996, 172 (01): : 75 - 78
  • [5] Hepatocellular carcinoma in an Australian tertiary referral hospital 1975-2002: Change in epidemiology and clinical presentation
    Roberts, Stuart K.
    Kemp, William
    [J]. JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 2007, 22 (02) : 191 - 196
  • [6] Intermediate uveitis: Etiologies and outcomes in a tertiary referral hospital in KSA
    Al-Hujaili, Haneen
    AlAbduljabbar, Khaled
    AlAkeely, Adel
    Al-Dhibi, Hassan
    [J]. SAUDI JOURNAL OF OPHTHALMOLOGY, 2021, 35 (02) : 81 - 83
  • [7] Characteristics and Outcomes of Upper Gastrointestinal Hemorrhage in a Tertiary Referral Hospital
    Halland, Magnus
    Young, Melissa
    Fitzgerald, Michael N.
    Inder, Kerry
    Duggan, John M.
    Duggan, Anne
    [J]. DIGESTIVE DISEASES AND SCIENCES, 2010, 55 (12) : 3430 - 3435
  • [8] Induction of labour: indications and obstetric outcomes in a tertiary referral hospital
    Buist, R
    Ranchhod, N
    [J]. NEW ZEALAND MEDICAL JOURNAL, 1999, 112 (1091) : 251 - 253
  • [9] Characteristics and Outcomes of Upper Gastrointestinal Hemorrhage in a Tertiary Referral Hospital
    Magnus Halland
    Melissa Young
    Michael N. Fitzgerald
    Kerry Inder
    John M. Duggan
    Anne Duggan
    [J]. Digestive Diseases and Sciences, 2010, 55 : 3430 - 3435
  • [10] Referral patterns of patients with systemic lupus erythematosus to an Australian tertiary care hospital
    Wong, M
    Boers, A
    Guymer, E
    Miller, M
    Littlejohn, G
    [J]. ANNALS OF THE RHEUMATIC DISEASES, 2003, 62 : 441 - 441