The Significance of Tumor Locations in Patients with Gallbladder Carcinoma After Curative-Intent Resection

ObjectiveTo evaluate the significance of tumor locations in patients with resected gallbladder carcinoma (GBC) and to supply the indication of extra-hepatic bile duct resection (EHBDR) according to tumor locations.MethodsPatients with resected GBC from 2010 to 2020 in our hospital were retrospectively analyzed. Comparative analyses and a meta-analysis were performed according to different tumor locations (body/fundus/neck/cystic duct).ResultsArticle: A total of 259 patients were identified (neck: 71; cystic: 29; body: 51; fundus: 108). Patients with proximal tumors (neck/cystic duct) were often in a more advanced stage and had more aggressive tumor biological features as well as a worse prognosis compared with those with distal tumors (fundus/body). Moreover, the observation was even more obvious between cystic duct and non-cystic duct tumors. Cystic duct tumor was an independent prognostic factor for overall survival (P = 0.01). EHBDR provided no survival advantage even in those with cystic duct tumor. Meta-analysis: With our own cohort incorporated, five studies with 204 patients with proximal tumors and 5167 patients with distal tumors were identified. Pooled results revealed that proximal tumors indicated worse tumor biological features and prognosis versus distal tumors.ConclusionProximal GBC had more aggressive tumor biological features, and a worse prognosis versus distal GBC and cystic duct tumor can be regarded as an independent prognostic factor. EHBDR had no obvious survival advantage even in those with cystic duct tumor and was even harmful in those with distal tumors. Upcoming more powerful well-designed studies are required for further validation.

Automated summary

The significance of tumor locations in patients with resected gallbladder carcinoma (GBC) has been evaluated in this study, aiming to provide indications for extra-hepatic bile duct resection (EHBDR) based on tumor locations. Comparative analyses and a meta-analysis were conducted on GBC patients who underwent resection between 2010 and 2020. The findings showed that proximal tumors (neck/cystic duct) were associated with more advanced stages, more aggressive tumor features, and worse prognosis compared to distal tumors (fundus/body). Moreover, cystic duct tumors were identified as an independent prognostic factor. EHBDR did not offer survival advantages, even in patients with cystic duct tumors, and it was even harmful in patients with distal tumors.