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Invasion of the Hepatic Artery is a Crucial Predictor of Poor Outcomes in Gallbladder Carcinoma

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Abstract

Background

In the present study we undertook a retrospective analysis of gallbladder carcinoma to assess whether histologically determined hepatic artery (HA) invasion and portal vein (PV) invasion can be considered prognostic factors.

Methods

Seventy-one patients who had undergone radical resection for gallbladder carcinoma between 1995 and 2008 at University of Tsukuba were selected from the database for analysis. Patients who required extended surgery for para-aortic lymph node metastasis were also included. Correlation between invasion of the HA and the PV and prognosis and other clinicopathologic factors were analyzed.

Results

There were two postoperative deaths among the 71 patients. Pathological invasion of the HA was confirmed in 16 (22.5%) cases and PV invasion was confirmed in 15 patients. Patients with invasion of the HA had a significantly poorer prognosis than those without HA invasion (P < 0.0001). Additionally, in univariate analysis, gender (male), positive para-aortic lymph node metastasis, PV invasion, and HA invasion were identified as significant poor prognostic factors. In multivariate analysis, only HA invasion was an independent prognostic factor (Odds Ratio 0.323; P = 0.029).

Conclusions

Invasion of the HA is a crucial prognostic factor in patients with gallbladder carcinoma.

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References

  1. Kondo S, Nimura Y, Hayakawa N et al (2000) Regional and para-aortic lymphadenectomy in radical surgery for advanced gallbladder carcinoma. Br J Surg 87:418–422

    Article  PubMed  CAS  Google Scholar 

  2. Shimada K, Nara S, Esaki M et al (2011) Extended right hemihepatectomy for gallbladder carcinoma involving the hepatic hilum. Br J Surg 98:117–123

    Article  PubMed  CAS  Google Scholar 

  3. International Union Against Cancer (2009) TNM classification of malignant tumors, 7th edn. Wiley, New York

    Google Scholar 

  4. Shimizu H, Kimura F, Yoshidome H et al (2007) Aggressive surgical approach for stage IV gallbladder carcinoma based on Japanese Society of Biliary Surgery classification. J Hepatobiliary Pancreat Surg 14:358–365

    Article  PubMed  Google Scholar 

  5. Kondo S, Nimura Y, Hayakawa N et al (2002) Extensive surgery for carcinoma of the gallbladder. Br J Surg 89:179–184

    PubMed  CAS  Google Scholar 

  6. Chijiiwa K, Kai M, Nagano M et al (2007) Outcome of radical surgery for stage IV gallbladder carcinoma. J Hepatobiliary Pancreat Surg 14:345–350

    Article  PubMed  Google Scholar 

  7. Donohue JH (2001) Present status of the diagnosis and treatment of gallbladder carcinoma. J Hepatobiliary Pancreat Surg 8:530–534

    Article  PubMed  CAS  Google Scholar 

  8. Todoroki T, Kawamoto T, Takahashi H et al (1999) Treatment of gallbladder cancer by radical resection. Br J Surg 86:622–627

    Article  PubMed  CAS  Google Scholar 

  9. Chijiiwa K, Noshiro H, Nakano K et al (2000) Role of surgery for gallbladder carcinoma with special reference to lymph node metastasis and stage using Western and Japanese classification systems. World J Surg 24:1271–1276. doi:10.1007/s002680010253, Discussion 1277

    Article  PubMed  CAS  Google Scholar 

  10. Miyazaki M, Itoh H, Ambiru S et al (1996) Radical surgery for advanced gallbladder carcinoma. Br J Surg 83:478–481

    Article  PubMed  CAS  Google Scholar 

  11. Kondo S, Nimura Y, Kamiya J et al (2003) Factors influencing postoperative hospital mortality and long-term survival after radical resection for stage IV gallbladder carcinoma. World J Surg 27:272–277. doi:10.1007/s00268-002-6654-4

    Article  PubMed  Google Scholar 

  12. Yamaguchi R, Nagino M, Oda K et al (2002) Perineural invasion has a negative impact on survival of patients with gallbladder carcinoma. Br J Surg 89:1130–1136

    Article  PubMed  CAS  Google Scholar 

  13. Kondo S, Takada T, Miyazaki M et al (2008) Guidelines for the management of biliary tract and ampullary carcinomas: surgical treatment. J Hepatobiliary Pancreat Surg 15:41–54

    Article  PubMed  Google Scholar 

  14. Kayahara M, Nagakawa T, Nakagawara H et al (2008) Prognostic factors for gallbladder cancer in Japan. Ann Surg 248:807–814

    Article  PubMed  Google Scholar 

  15. Sasaki E, Nagino M, Ebata T et al (2006) Immunohistochemically demonstrated lymph node micrometastasis and prognosis in patients with gallbladder carcinoma. Ann Surg 244:99–105

    Article  PubMed  Google Scholar 

  16. Rodriguez-Fernandez A, Gomez-Rio M, Medina-Benitez A et al (2006) Application of modern imaging methods in diagnosis of gallbladder cancer. J Surg Oncol 93:650–664

    Article  PubMed  Google Scholar 

  17. Jensen EH, Abraham A, Jarosek S et al (2009) Lymph node evaluation is associated with improved survival after surgery for early stage gallbladder cancer. Surgery 146:706–711 Discussion 711–713

    Article  PubMed  Google Scholar 

  18. Fong Y, Wagman L, Gonen M et al (2006) Evidence-based gallbladder cancer staging: changing cancer staging by analysis of data from the National Cancer Database. Ann Surg 243:767–771 discussion 771–774

    Article  PubMed  Google Scholar 

  19. Benoist S, Panis Y, Fagniez PL (1998) Long-term results after curative resection for carcinoma of the gallbladder. French University Association for Surgical Research. Am J Surg 175:118–122

    Article  PubMed  CAS  Google Scholar 

  20. Tsukada K, Kurosaki I, Uchida K et al (1997) Lymph node spread from carcinoma of the gallbladder. Cancer 80:661–667

    Article  PubMed  CAS  Google Scholar 

  21. Park JS, Yoon DS, Kim KS et al (2007) Actual recurrence patterns and risk factors influencing recurrence after curative resection with stage II gallbladder carcinoma. J Gastrointest Surg 11:631–637

    Article  PubMed  Google Scholar 

  22. Kim WS, Choi DW, You DD et al (2010) Risk factors influencing recurrence, patterns of recurrence, and the efficacy of adjuvant therapy after radical resection for gallbladder carcinoma. J Gastrointest Surg 14:679–687

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors are grateful to Flaminia Miyamasu for correcting the English in our manuscript.

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Correspondence to Akihiko Kobayashi.

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Kobayashi, A., Oda, T., Fukunaga, K. et al. Invasion of the Hepatic Artery is a Crucial Predictor of Poor Outcomes in Gallbladder Carcinoma. World J Surg 36, 645–650 (2012). https://doi.org/10.1007/s00268-011-1413-z

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