Rates and patterns of recurrence after curative intent resection for gallbladder cancer: a multi-institution analysis from the US Extra-hepatic Biliary Malignancy Consortium

Georgios Antonios Margonis, Faiz Gani, Stefan Buettner, Neda Amini, Kazunari Sasaki, Nikolaos Andreatos, Cecilia G. Ethun, George Poultsides, Thuy Tran, Kamran Idrees, Chelsea A. Isom, Ryan C. Fields, Bradley Krasnick, Sharon M. Weber, Ahmed Salem, Robert C G Martin, Charles Scoggins, Perry Shen, Harveshp D. Mogal, Carl SchmidtEliza Beal, Ioannis Hatzaras, Rivfka Shenoy, Shishir K. Maithel, Timothy M. Pawlik

Research output: Contribution to journalArticlepeer-review

Abstract

Background Gallbladder cancer is a relatively rare malignancy. The current study aimed to define the incidence and patterns of recurrence following gallbladder cancer resection. Methods Using a multi-institutional cohort we identified 217 patient undergoing curative intent surgery for gallbladder cancer. Patterns of recurrence were classified as locoregional and distant recurrence. Results At last follow-up, 76 patients (35.0%) had experienced a recurrence (locoregional only, n = 12, 15.8%; distant only, n = 50, 65.8%; locoregional and distant, n = 14, 18.4%). Median time to recurrence was 9.5 months (IQR 4.7–17.6) and was not associated with recurrence site (all p > 0.05). On multivariable analysis, T3 disease (HR = 8.44, p = 0.014), lymphovascular invasion (HR = 4.24, p < 0.001) and residual disease (HR = 2.04, p = 0.042) were associated with an increased risk of recurrence. Patients who recurred demonstrated a worse 1-, 3- and 5-year OS (1-year OS: 91.3% vs. 68.6%, p = 0.001, 3-year OS: 79.3% vs. 28.7%, p < 0.001, and 5-year OS: 75.9% vs. 16.0%, p < 0.001). After adjusting for other risk factors, recurrence was independently associated with a decreased OS (HR = 3.71, p = 0.006). Of note, receipt of adjuvant therapy was associated with improved OS (HR = 0.56, p = 0.027) among those patients who developed a tumor recurrence. Discussion Over one-third of patients experienced a recurrence after gallbladder cancer surgery. While chemotherapy did not decrease the rate of recurrence, patients who experienced recurrence after administration of adjuvant treatment faired better than patients who did not receive adjuvant therapy.

Original languageEnglish (US)
Pages (from-to)872-878
Number of pages7
JournalHPB
Volume18
Issue number11
DOIs
StatePublished - Nov 1 2016

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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