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Early Recurrence in Resected Gallbladder Carcinoma: Clinical Impact and Its Preoperative Predictive Score

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Surgical resection is the only potentially curative therapy for gallbladder carcinoma (GBC). However, the postoperative recurrence rate is high (approximately 50%), and recurrence occasionally develops early after surgery.

Patients and Methods

A total of 139 patients who underwent macroscopically curative resection for GBC between 2002 and 2018 were retrospectively reviewed. Early recurrence (ER) was defined as recurrence within 6 months after surgery. Univariate and multivariate logistic regression analysis was performed using preoperative factors that may influence early recurrence, namely patient background factors, tumor markers, imaging findings, and body composition parameters obtained preoperatively, to create a predictive score for ER.

Results

The median follow-up period was 21.9 months (range, 6.2–195.7 months). Postoperative recurrence was observed in 55 (39.6%) patients, of whom 14 (25.5%) developed ER. The median overall survival after surgery was 104.7 months for the non-ER group and 15.7 months for the ER group. On multivariate analysis, high carbohydrate antigen 19-9, low muscle attenuation, high visceral fat attenuation, liver invasion, and other organ invasion on preoperative computed tomography were identified as independent risk factors for ER. A preoperatively predictive scoring system for ER was constructed by weighting the above five factors. The nomogram showed an area under the curve of 0.881, indicating good predictive potential for ER.

Conclusions

ER in resected GBC indicates a very poor prognosis. The present preoperative scoring system can sufficiently predict ER and may be helpful in determining the optimal treatment strategies.

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Acknowledgment

We thank Jane Charbonneau, DVM, from Edanz (https://jp.edanz.com/ac) for editing a draft of this manuscript.

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Authors and Affiliations

  1. Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Sunto-Nagaizumi, Shizuoka, Japan

    Yuji Shimizu MD, Ryo Ashida MD, PhD, Teiichi Sugiura MD, PhD, Yukiyasu Okamura MD, PhD, Katsuhisa Ohgi MD, Mihoko Yamada MD, PhD, Shimpei Otsuka MD, PhD & Katsuhiko Uesaka MD, PhD

  2. Division of Interventional Radiology, Shizuoka Cancer Center, Sunto-Nagaizumi, Shizuoka, Japan

    Takeshi Aramaki MD, PhD

  3. Clinical Research Center, Shizuoka Cancer Center, Sunto-Nagaizumi, Shizuoka, Japan

    Akifumi Notsu MD, PhD

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Correspondence to Ryo Ashida MD, PhD.

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Shimizu, Y., Ashida, R., Sugiura, T. et al. Early Recurrence in Resected Gallbladder Carcinoma: Clinical Impact and Its Preoperative Predictive Score. Ann Surg Oncol 29, 5447–5457 (2022). https://doi.org/10.1245/s10434-022-11937-y

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