Analysis of the Extent of Liver Oncological Extended Resection for Incidental Gallbladder Cancer: How Much Is Too Much?

dc.contributor.authorVega, Eduardo A.
dc.contributor.authorMellado, Sebastian
dc.contributor.authorChirban, Ariana M.
dc.contributor.authorPanettieri, Elena
dc.contributor.authorSanhueza, Marcel
dc.contributor.authorMege, Rosemarie
dc.contributor.authorDiaz, Cristian
dc.contributor.authorBranes, Alejandro
dc.contributor.authorBriceno, Eduardo
dc.contributor.authorVinuela, Eduardo
dc.date.accessioned2025-01-20T20:07:27Z
dc.date.available2025-01-20T20:07:27Z
dc.date.issued2023
dc.description.abstractBackground. Liver resection is pivotal in treating incidental gallbladder cancer (IGBC). However, the adequate volume of liver resection remains controversial.
dc.description.abstractMethods. A cross-sectional retrospective analysis was performed on resected IGBC patients between 1999 and 2018. Morbidity was evaluated according to the Clavien-Dindo classification. The theoretical volume of a 2-cm and 1.5-cm wedge liver resection was calculated (105 cm(3) and 77.5 cm(3), respectively) and used as reference. Overall survival (OS) was estimated using Kaplan-Meier and Cox regression analyses.
dc.description.abstractResults. Among 111 patients re-resected for IGBC, 84 provided sufficient data to calculate liver resection volume. Patients with a resection volume >= 105 cm(3) had a higher rate of overall morbidity (P = 0.001) and length of stay (P = 0.012), with no difference in mortality. There was no significant difference in OS according to residual cancer or T-category. A resection volume >= 77.5 cm(3) was more frequent in T = 3 than in T1-2 patients (P = 0.026), and residual cancer was higher (P = 0.041) among patients with >= 77.5 cm(3) resected. Cox multivariate regression showed that residual cancer (HR = 11.47, P < 0.001), perineural/lymphovascular invasion (HR = 2.48, P = 0.021), and Clavien-Dindo >= IIIa morbidity (HR = 5.03, P = 0.003) predict worse OS, but not liver volume resection.
dc.description.abstractConclusion. There are no significant differences in OS based on resected liver volume of IGBC, when R0 is achieved. There is a significant difference in morbidity and length of stay when liver wedges are >= 105 cm(3), which is lost when analyzed by Clavien-Dindo >= IIIa. A 77.5-105 cm(3) resection is indicated in >= T3 patients, minimizing morbidity risk, while addressing concerns of overall survival.
dc.fuente.origenWOS
dc.identifier.doi10.1245/s10434-023-13861-1
dc.identifier.eissn1534-4681
dc.identifier.issn1068-9265
dc.identifier.urihttps://doi.org/10.1245/s10434-023-13861-1
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/91804
dc.identifier.wosidWOS:001048578200004
dc.issue.numero11
dc.language.isoen
dc.pagina.final6600
dc.pagina.inicio6594
dc.revistaAnnals of surgical oncology
dc.rightsacceso restringido
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleAnalysis of the Extent of Liver Oncological Extended Resection for Incidental Gallbladder Cancer: How Much Is Too Much?
dc.typeartículo
dc.volumen30
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
Files