Effect of preoperative jaundice on long-term prognosis of gallbladder carcinoma with radical resection
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(2020) 18:239
RESEARCH
Open Access
Effect of preoperative jaundice on longterm prognosis of gallbladder carcinoma with radical resection Xin-wei Yang1†, Jun-yi Chen2†, Zhi-jian Wen3†, Yu-long Li1†, Fei-yu Wang4†, Liang Li1, Jue Yang1, Ping-hua Yang1, Bao-hua Zhang1* and Feng Shen1*
Abstract Purposes: This study was designed to evaluate the effect of preoperative jaundice on long-term prognosis of gallbladder carcinoma (GBC) after radical resection (R0). Methods: A total of 267 GBC patients who underwent R0 resection from January 2004 to December 2014 were enrolled, including 54 patients with preoperative jaundice and 213 patients without jaundice. The clinicopathological parameters between the two groups were compared, and the correlation between preoperative jaundice and the long-term prognosis was furtherly analyzed. Results: Unilateral and multivariate analyses of 267 GBC patients showed that the depth of tumor invasion (pT stage), lymphatic metastasis, and hepatic invasion were independent prognostic factors. The univariate and multivariate analysis of 54 GBC patients with preoperative jaundice showed that only pT stage was an independent factor for prognosis. Furthermore, the intraoperative blood transfusion and pT stage were significant different between longterm survival (survive for more than 3 years) and those who died within 3 years (P < 0.05). Conclusion: Preoperative jaundice was not the independent factor resulting in the poor long-term prognosis of gallbladder carcinoma after R0 resection. The pT stage was the only long-term prognostic factor in all GBC patients regardless of preoperative jaundice. Keywords: Jaundice, Gallbladder carcinoma, R0, Long-term prognosis, pT stage
Introduction Gallbladder carcinoma (GBC) that has invaded the submucosa without lymph node metastasis may have a favorable prognosis after surgical resection [1]. However, GBC has a tendency to invade the surrounding organs, especially to the hilar and hepatoduodenal ligaments. This usually leads to obstructive jaundice, which usually
* Correspondence: [email protected]; [email protected] † Xin-wei Yang, Jun-yi Chen,Zhi-jian Wen, Yu-long Li and Fei-yu Wang contributed equally to this work. 1 Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Changhai Road 225, Shanghai 200438, China Full list of author information is available at the end of the article
indicates that the disease is in advanced stage and cannot be surgically resected [2]. Previous reports have suggested that GBC patients with preoperative jaundice were significantly associated with poor prognosis [3–7]. In addition, some recent studies also have found that preoperative jaundice or extrahepatic bile duct invasion were independent predictors of poor prognosis [8, 9]. Even so, some scholars supported surgical resection in such advanced patients [10, 11]. Our previous study [12] has found that the jaundiced patients have lower survival rates than the non-jaundiced patients. The multivariate analysis showed that preoperative jaundic
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