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Prognostic Significance of Tumor Necrosis in Patients with Gallbladder Carcinoma Undergoing Curative-Intent Resection

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

Abstract

Background

Tumor necrosis has been indicated to correlate with dismal survival outcomes of a variety of solid tumors. However, the significance and prognostic value of tumor necrosis remain unclear in gallbladder carcinoma. The aim of this research is to explore the relationships between necrosis with long-term survival and tumor-related biological characteristics of patients with gallbladder carcinoma.

Patients and Methods

Patients with gallbladder carcinoma who accepted curative-intent resection in West China Hospital of Sichuan University (China) between January 2010 and December 2021 were retrospectively analyzed. Tumor necrosis was determined by staining the patient’s original tissue sections with hematoxylin and eosin. Based on the presence of tumor necrosis, the pathologic features and survival outcomes were compared.

Results

This study enrolled 213 patients with gallbladder carcinoma who underwent curative-intent surgery, of whom 89 had tumor necrosis. Comparative analyses indicated that patients with tumor necrosis had more aggressive clinicopathological features, such as larger tumor size (p = 0.002), poorer tumor differentiation (p = 0.029), more frequent vascular invasion (p < 0.001), presence of lymph node metastasis (p = 0.014), and higher tumor status (p = 0.01), and experienced poorer survival. Univariate and multivariate analyses revealed that tumor necrosis was an independent prognostic factor for overall survival (multivariate: HR 1.651, p = 0.026) and disease-free survival (multivariate: HR 1.589, p = 0.040).

Conclusions

Tumor necrosis can be considered as an independent predictive factor for overall survival and disease-free survival among individuals with gallbladder carcinoma, which was a valuable pathologic parameter.

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Data Availability

All data generated or analyzed during this study are included in the published article.

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Acknowledgement

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Funding

This work was supported by 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (ZYJC21046); 1.3.5 project for disciplines of excellence—Clinical Research Incubation project, West China Hospital, Sichuan University (2021HXFH001); Natural Science Foundation of Sichuan Province (2022NSFSC0806); National Natural Science Foundation of China for Young Scientists fund (82203782), Sichuan Science and Technology program (2021YJ0132, 2021YFS0100); the fellowship of China Postdoctoral Science Foundation (2021M692277); Sichuan University-Zigong school-local cooperation project (2021CDZG-23); Science and Technology project of the Health Planning Committee of Sichuan (21PJ046); post-doctor research project, West China Hospital, Sichuan University (2021HXBH127).

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Authors and Affiliations

  1. Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

    Si-qi Yang MD, Jun-ke Wang MD, Wen-jie Ma MD, Fei Liu MD, Rui-qi Zou MD, Yu-shi Dai MD, Tian-run Lv MD, Fu-yu Li MD, PhD & Hai-jie Hu MD, PhD

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  1. Si-qi Yang MD
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Contributions

YSQ contributed to data acquisition and drafted the manuscript. WJK, MWJ, LF, DYS, ZRQ, and LTR contributed to data acquisition. LFY and HHJ contributed to the study design and revision of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Fu-yu Li MD, PhD or Hai-jie Hu MD, PhD.

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The authors have no conflicts of interest to disclose.

Ethical Approval

This study was approved by the Medical Ethics Committee of the West China Hospital of Sichuan University.

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Yang, Sq., Wang, Jk., Ma, Wj. et al. Prognostic Significance of Tumor Necrosis in Patients with Gallbladder Carcinoma Undergoing Curative-Intent Resection. Ann Surg Oncol 31, 125–132 (2024). https://doi.org/10.1245/s10434-023-14421-3

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  • DOI: https://doi.org/10.1245/s10434-023-14421-3

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