Adeno-squamous and squamous cell carcinoma of the gallbladder: The importance of histology in surgical management.
Aged
Carcinoma, Adenosquamous
/ mortality
Carcinoma, Squamous Cell
/ mortality
Colon
/ surgery
Common Bile Duct
/ surgery
Duodenum
/ surgery
Female
Gallbladder Neoplasms
/ mortality
Hepatectomy
Humans
Liver
/ pathology
Lymph Node Excision
Male
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Omentum
/ surgery
Progression-Free Survival
Retrospective Studies
Survival Analysis
Adeno-squamous
Gallbladder cancer
Histology
Squamous
Survival
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
received:
14
02
2020
revised:
29
04
2020
accepted:
25
06
2020
pubmed:
11
7
2020
medline:
5
1
2021
entrez:
11
7
2020
Statut:
ppublish
Résumé
Although gallbladder adenocarcinoma (AC) is potentially curable with resection, outcomes of squamous histologies are poorly described. We retrospectively analyzed all gallbladder cancers which underwent resection-for-cure in our health system from 2007 to 2017. We compared outcomes of AC to adeno-squamous (ASC)/squamous (SC) histologies. 91 patients met criteria; 76 AC, 15 ASC/SC. Compared to AC, ASC/SC tumors were larger (58 vs. 28 mm), with more frequent liver invasion (73% vs. 37%), pN+ (60% vs. 32%), higher stage (III/IV 73% vs. 52%), and displayed more LVI (60% vs. 36%), p < 0.05. For stage III/IV disease, provided R0 was achieved, survival was durable and similar for ASC/SC and AC (OS median 28mo ASC/SC vs. 25mo AC, p = 0.132; PFS median 21mo ASC/SC vs. 13mo AC, p = 0.206). Pure SC had considerably poorer median OS (<5mo) than ASC (23mo) and AC (28mo). Squamous variants of gallbladder cancer confer aggressive and advanced disease and often require more radical resections to achieve R0. Durable survival is possible in ASC provided R0 is achieved. Pure SC has dismal survival even with R0 resection.
Sections du résumé
BACKGROUND
Although gallbladder adenocarcinoma (AC) is potentially curable with resection, outcomes of squamous histologies are poorly described.
METHODS
We retrospectively analyzed all gallbladder cancers which underwent resection-for-cure in our health system from 2007 to 2017. We compared outcomes of AC to adeno-squamous (ASC)/squamous (SC) histologies.
RESULTS
91 patients met criteria; 76 AC, 15 ASC/SC. Compared to AC, ASC/SC tumors were larger (58 vs. 28 mm), with more frequent liver invasion (73% vs. 37%), pN+ (60% vs. 32%), higher stage (III/IV 73% vs. 52%), and displayed more LVI (60% vs. 36%), p < 0.05. For stage III/IV disease, provided R0 was achieved, survival was durable and similar for ASC/SC and AC (OS median 28mo ASC/SC vs. 25mo AC, p = 0.132; PFS median 21mo ASC/SC vs. 13mo AC, p = 0.206). Pure SC had considerably poorer median OS (<5mo) than ASC (23mo) and AC (28mo).
DISCUSSION
Squamous variants of gallbladder cancer confer aggressive and advanced disease and often require more radical resections to achieve R0. Durable survival is possible in ASC provided R0 is achieved. Pure SC has dismal survival even with R0 resection.
Identifiants
pubmed: 32646581
pii: S0002-9610(20)30405-0
doi: 10.1016/j.amjsurg.2020.06.050
pii:
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1242-1248Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of competing interest None.