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Survival analysis following resection of AJCC stage III gallbladder carcinoma based on different combinations of T and N stages.

Hwang KY, Yoon YI, Hwang S, Ha TY, Ahn CS, Kim KH, Moon DB, Song GW, Jung DH, Lee YJ, Park KM, Lee SG - Korean J Hepatobiliary Pancreat Surg (2015)

Bottom Line: Overall 5-year survival rate based on all-cause death and cancer-associated death, respectively, was 57.7% and 60.6% in T3N0, 15.4% and 15.4% in T1N1 (n=13), 28.6% and 28.6% in T2N1 (n=35), 5.0% and 5.7% in T3N1 (n=20), and 22.2% and 22.2% in T1-3N2.The survival outcome of T3N1 group was the poorest among the four stage III groups and was comparable to that of stage IVB (p=0.53).Further validation of this result is necessary in large patient populations from multiple centers.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Backgrounds/aims: According to 7th AJCC TNM staging system, gallbladder carcinoma (GBC) with lymph node (LN) metastasis is classified as N1 or N2; thus making the stage IIIB (N1) or IVB (N2). Stage IIIB consists of N1 status with wide coverage of T1-3, but T3N1 group often showed poorer outcomes than T1-2N1 groups. This study intended to assess post-resection prognosis of T3N1 versus other stage III subgroups.

Methods: We selected 103 patients from our institutional database of GBC who underwent R0 resection between July 1996 and June 2009 and whose GBC was confined to stage T3N0, T1-3N1 or T1-3N2. These patients were stratified into five groups, namely, T3N0 (n=26), T1N1 (n=13), T2N1 (n=35), T3N1 (n=20) and T1-3N2 (n=9), and were followed for ≥5 years or until death.

Results: Surgical procedures were minor liver resection (n=53), minor liver resection with bile duct resection (n=23), major liver resection (n=12), major liver resection with bile duct resection (n=5), and hepatopancreatoduodenectomy (n=12). Mean follow-up period was 57.2±68.5 months. Overall 5-year survival rate based on all-cause death and cancer-associated death, respectively, was 57.7% and 60.6% in T3N0, 15.4% and 15.4% in T1N1 (n=13), 28.6% and 28.6% in T2N1 (n=35), 5.0% and 5.7% in T3N1 (n=20), and 22.2% and 22.2% in T1-3N2. The survival outcome of T3N1 group was the poorest among the four stage III groups and was comparable to that of stage IVB (p=0.53).

Conclusions: The prognosis of T3N1 GBC is unusually poor even after R0 resection, thus we suggest extensive LN dissection may be necessary in patients with T3 tumors for accurate prognostic evaluation and radical removal of potential nodal micrometastasis. Further validation of this result is necessary in large patient populations from multiple centers.

No MeSH data available.


Related in: MedlinePlus

Comparison of the overall survival curves of the five groups based on all-cause death.
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Figure 1: Comparison of the overall survival curves of the five groups based on all-cause death.

Mentions: The mean and median follow-up periods were 57.2±68.5 months and 21 months, respectively. The overall survival curves of the five groups based on all-cause death are depicted in Fig. 1. At the end of follow-up, 23 patients were alive: 75 died from tumor recurrence and five died of other causes (other gastrointestinal malignancy in two patients, cerebrovascular accident in two patients and pneumonia in one patient). The overall 5-year survival rate based on all-cause death was 57.7% in T3N0 (n=26), 15.4% in T1N1 (n=13), 28.6% in T2N1 (n=35), 5.0% in T3N1 (n=20), and 22.2% in T1-3N2 (n=9: T1N2 in 1, T2N2 in 3 and T3N2 in 5).


Survival analysis following resection of AJCC stage III gallbladder carcinoma based on different combinations of T and N stages.

Hwang KY, Yoon YI, Hwang S, Ha TY, Ahn CS, Kim KH, Moon DB, Song GW, Jung DH, Lee YJ, Park KM, Lee SG - Korean J Hepatobiliary Pancreat Surg (2015)

Comparison of the overall survival curves of the five groups based on all-cause death.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4494090&req=5

Figure 1: Comparison of the overall survival curves of the five groups based on all-cause death.
Mentions: The mean and median follow-up periods were 57.2±68.5 months and 21 months, respectively. The overall survival curves of the five groups based on all-cause death are depicted in Fig. 1. At the end of follow-up, 23 patients were alive: 75 died from tumor recurrence and five died of other causes (other gastrointestinal malignancy in two patients, cerebrovascular accident in two patients and pneumonia in one patient). The overall 5-year survival rate based on all-cause death was 57.7% in T3N0 (n=26), 15.4% in T1N1 (n=13), 28.6% in T2N1 (n=35), 5.0% in T3N1 (n=20), and 22.2% in T1-3N2 (n=9: T1N2 in 1, T2N2 in 3 and T3N2 in 5).

Bottom Line: Overall 5-year survival rate based on all-cause death and cancer-associated death, respectively, was 57.7% and 60.6% in T3N0, 15.4% and 15.4% in T1N1 (n=13), 28.6% and 28.6% in T2N1 (n=35), 5.0% and 5.7% in T3N1 (n=20), and 22.2% and 22.2% in T1-3N2.The survival outcome of T3N1 group was the poorest among the four stage III groups and was comparable to that of stage IVB (p=0.53).Further validation of this result is necessary in large patient populations from multiple centers.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT

Backgrounds/aims: According to 7th AJCC TNM staging system, gallbladder carcinoma (GBC) with lymph node (LN) metastasis is classified as N1 or N2; thus making the stage IIIB (N1) or IVB (N2). Stage IIIB consists of N1 status with wide coverage of T1-3, but T3N1 group often showed poorer outcomes than T1-2N1 groups. This study intended to assess post-resection prognosis of T3N1 versus other stage III subgroups.

Methods: We selected 103 patients from our institutional database of GBC who underwent R0 resection between July 1996 and June 2009 and whose GBC was confined to stage T3N0, T1-3N1 or T1-3N2. These patients were stratified into five groups, namely, T3N0 (n=26), T1N1 (n=13), T2N1 (n=35), T3N1 (n=20) and T1-3N2 (n=9), and were followed for ≥5 years or until death.

Results: Surgical procedures were minor liver resection (n=53), minor liver resection with bile duct resection (n=23), major liver resection (n=12), major liver resection with bile duct resection (n=5), and hepatopancreatoduodenectomy (n=12). Mean follow-up period was 57.2±68.5 months. Overall 5-year survival rate based on all-cause death and cancer-associated death, respectively, was 57.7% and 60.6% in T3N0, 15.4% and 15.4% in T1N1 (n=13), 28.6% and 28.6% in T2N1 (n=35), 5.0% and 5.7% in T3N1 (n=20), and 22.2% and 22.2% in T1-3N2. The survival outcome of T3N1 group was the poorest among the four stage III groups and was comparable to that of stage IVB (p=0.53).

Conclusions: The prognosis of T3N1 GBC is unusually poor even after R0 resection, thus we suggest extensive LN dissection may be necessary in patients with T3 tumors for accurate prognostic evaluation and radical removal of potential nodal micrometastasis. Further validation of this result is necessary in large patient populations from multiple centers.

No MeSH data available.


Related in: MedlinePlus