Defining and Predicting Early Recurrence after Resection for Gallbladder Cancer
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ORIGINAL ARTICLE – HEPATOBILIARY TUMORS
Defining and Predicting Early Recurrence after Resection for Gallbladder Cancer Kota Sahara, MD1,2, Diamantis I. Tsilimigras, MD2, Yutaro Kikuchi, MD, PhD1,2, Cecilia G. Ethun, MD3, Shishir K. Maithel, MD3, Daniel E. Abbott, MD4, George A. Poultsides, MD5, Ioannis Hatzaras, MD6, Ryan C. Fields, MD7, Matthew Weiss, MD8, Charles Scoggins, MD9, Chelsea A. Isom, MD10, Kamran Idrees, MD10, Perry Shen, MD11, Yasuhiro Yabushita, MD, PhD1, Ryusei Matsuyama, MD, PhD1, Itaru Endo, MD, PhD1, and Timothy M. Pawlik, MD, MPH, PhD, FACS2 1
Department of Gastroenterological Surgery, Yokohama City University School of Medicine, Yokohama, Japan; 2Division of Surgical Oncology, Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, James Comprehensive Cancer Center, The Ohio State University Wexner Medical Center, Columbus, OH; 3Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA; 4Department of Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI; 5Department of Surgery, Stanford University Medical Center, Stanford, CA; 6Department of Surgery, New York University, New York, NY; 7Department of Surgery, Washington University School of Medicine, St. Louis, MO; 8Department of Surgery, Johns Hopkins Hospital, Baltimore, MD; 9Division of Surgical Oncology, Department of Surgery, University of Louisville, Louisville, KY; 10 Division of Surgical Oncology, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN; 11 Department of Surgery, Wake Forest University, Winston-Salem, NC
ABSTRACT Background. The optimal time interval to define early recurrence (ER) among patients who underwent resection of gallbladder cancer (GBC) is not well defined. We sought to develop and validate a novel GBC recurrence risk (GBRR) score to predict ER among patients undergoing resection for GBC. Patients and Methods. Patients who underwent curativeintent resection for GBC between 2000 and 2018 were identified from the US Extrahepatic Biliary Malignancy Consortium database. A minimum p value approach in the log-rank test was used to define the optimal cutoff for ER. A risk stratification model was developed to predict ER
Electronic supplementary material The online version of this article (https://doi.org/10.1245/s10434-020-09108-y) contains supplementary material, which is available to authorized users. Ó Society of Surgical Oncology 2020 First Received: 18 June 2020 Accepted: 18 August 2020 T. M. Pawlik, MD, MPH, PhD, FACS e-mail: [email protected]
based on relevant clinicopathological factors and was externally validated. Results. Among 309 patients, 103 patients (33.3%) had a recurrence at a median follow-up period of 15.1 months. The optimal cutoff for ER was defined at 12 months (p = 3.04 9 10-18). On multivariable analysis, T3/T4 disease (HR: 2.80; 95% CI 1.58–5.11) and poor tumor differentiation (HR: 1.91; 95% CI 1.11–3.25) were associated with greater hazards of ER. The
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