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Can patients with gallbladder adenocarcinoma and liver metastases obtain survival benefit from surgery? A population-based study

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Abstract

According to international guidelines, surgical treatment is not recommended for gallbladder adenocarcinoma with liver metastases (GCL), and research on the clinical implications of surgery in GCL is very scarce. In this study, we aimed to investigate whether surgery is an effective means to improve survival in GCL. Data were collected from the Surveillance, Epidemiology, and End Results database. A total of 612 people diagnosed with GCL were identified. According to their treatment, patients were categorised into 4 groups: synchronous resection of the primary tumour and liver metastases (SPL), synchronous primary site and other resection (SPO), single resection of the primary site (SPS), and no resection (NR). Our study findings showed that 34 (5.6%) patients received SPL, 18 (2.9%) had SPO, 185 (30.2%) underwent SPS, and 375 (61.3%) received NR. Our analysis showed that surgical treatment was an independent protective prognostic factor for gallbladder cancer cause-specific survival. Groups who underwent SPL, SPO, and SPS showed gradually decreasing survival benefit compared with the NR group (median survival: 9, 5, 4, and 2 months, respectively). Notably, mortality in the SPL, SPO, and SPS groups were significantly different compared with NR group, and the hazard ratio were gradually increased, which were 0.402 (95% confidence interval [CI] 0.264–0.611), 0.463 (95% CI 0.274–0.784), and 0.597 (95% CI 0.457–0.779), respectively (all P < 0.05). Survival in patients with GCL was significantly improved via surgery of the primary site with simultaneous metastasectomy. Among them, SPL and SPO showed greater survival advantages in carefully selected patients with GCL. Registered at researchregistery.com: Trial registration number is researchregistry6915.

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Availability of data and materials

The data that support the findings of this study are openly available in National Cancer Institute's Surveillance Epidemiology and End Result SEER at https://seer.cancer.gov/.

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Acknowledgements

The authors acknowledge the efforts of the SEER program in the creation of the SEER database

Funding

This work was supported by the National Natural Science Foundation of China Grant (No. 82173353) and the Top talent scientific research project of “six one projects” (LGY2018028).

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Author notes

  1. Tianming Gao, Hua Tang and Baohuan Zhou contributed equally to this work.

Authors and Affiliations

  1. Department of Hepatobiliary Surgery, Clinical Medical College, Yangzhou University, Yangzhou, 225001, China

    Tianming Gao, Baohuan Zhou, Dousheng Bai, Shengjie Jin, Chi Zhang & Guoqing Jiang

  2. The Administration Office, Yangzhou Blood Center, Yangzhou, 225001, China

    Hua Tang

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  1. Tianming Gao
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  2. Hua Tang
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Contributions

GTM: conceptualisation, data curation, supervision, and writing—original draft. TH: conceptualisation, formal analysis, writing—original draft, and supervision. ZBH: conceptualisation, formal analysis, and writing—review and editing. BDS: methodology and title page project administration. JSJ: data curation, resources, software, formal analysis, validation, and visualisation. ZC: investigation, methodology, and project administration. JGQ: conceptualisation, supervision, formal analysis, funding acquisition, and writing—review and editing.

Corresponding author

Correspondence to Guoqing Jiang.

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Conflict of interest

All the authors declare no conflicts of interest.

Ethics approval statement

The SEER Program collects data from population-based cancer registries with anonymous information. The SEER is a publicly available database and data extracted from SEER was deemed “non-human study” by the North Shore LIJ IRB committee.

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As this study is based on a publicly available database without identifying patient information, informed consent was not needed.

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Gao, T., Tang, H., Zhou, B. et al. Can patients with gallbladder adenocarcinoma and liver metastases obtain survival benefit from surgery? A population-based study. Updates Surg 74, 1353–1366 (2022). https://doi.org/10.1007/s13304-022-01302-9

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  • DOI: https://doi.org/10.1007/s13304-022-01302-9

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