Publication:
Surgical outcomes of gallbladder cancer: the OMEGA retrospective, multicentre, international cohort study

dc.contributor.coauthorBalakrishnan, Anita
dc.contributor.coauthorBarmpounakis, Petros
dc.contributor.coauthorDemiris, Nikolaos
dc.contributor.coauthorJah, Asif
dc.contributor.coauthorSpiers, Harry V. M.
dc.contributor.coauthorTalukder, Shibojit
dc.contributor.coauthorMartin, Jack L.
dc.contributor.coauthorGibbs, Paul
dc.contributor.coauthorHarper, Simon J. F.
dc.contributor.coauthorHuguet, Emmanuel L.
dc.contributor.coauthorKosmoliaptsis, Vasilis
dc.contributor.coauthorLiau, Siong S.
dc.contributor.coauthorPraseedom, Raaj K.
dc.contributor.coauthorBasu, Bristi
dc.contributor.coauthorde Aretxabala, Xavier
dc.contributor.coauthorLendoire, Javier
dc.contributor.coauthorMaithel, Shishir
dc.contributor.coauthorBranes, Alejandro
dc.contributor.coauthorAndersson, Bodil
dc.contributor.coauthorSerrablo, Alejandro
dc.contributor.coauthorOMEGA Study Investigators
dc.contributor.departmentKUH (Koç University Hospital)
dc.contributor.departmentSchool of Medicine
dc.contributor.kuauthorAdsay, Nazmi Volkan
dc.contributor.schoolcollegeinstituteKUH (KOÇ UNIVERSITY HOSPITAL)
dc.contributor.schoolcollegeinstituteSCHOOL OF MEDICINE
dc.date.accessioned2025-01-19T10:27:44Z
dc.date.issued2023
dc.description.abstractBackground Gallbladder cancer (GBC) is rare but aggressive. The extent of surgical intervention for different GBC stages is non-uniform, ranging from cholecystectomy alone to extended resections including major hepatectomy, resection of adjacent organs and routine extrahepatic bile duct resection (EBDR). Robust evidence here is lacking, however, and survival benefit poorly defined. This study assesses factors associated with recurrence-free survival (RFS), overall survival (OS) and morbidity and mortality following GBC surgery in high income countries (HIC) and low and middle income countries (LMIC).Methods The multicentre, retrospective Operative Management of Gallbladder Cancer (OMEGA) cohort study included all patients who underwent GBC resection across 133 centres between 1st January 2010 and 31st December 2020. Regression analyses assessed factors associated with OS, RFS and morbidity.Findings On multivariable analysis of all 3676 patients, wedge resection and segment IVb/V resection failed to improve RFS (HR 1.04 [0.84-1.29], p = 0.711 and HR 1.18 [0.95-1.46], p = 0.13 respectively) or OS (HR 0.96 [0.79-1.17], p = 0.67 and HR 1.48 [1.16-1.88], p = 0.49 respectively), while major hepatectomy was associated with worse RFS (HR 1.33 [1.02-1.74], p = 0.037) and OS (HR 1.26 [1.03-1.53], p = 0.022). Furthermore, EBDR (OR 2.86 [2.3-3.52], p < 0.0010), resection of additional organs (OR 2.22 [1.62-3.02], p < 0.0010) and major hepatectomy (OR 3.81 [2.55-5.73], p < 0.0010) were all associated with increased morbidity and mortality. Compared to LMIC, patients in HIC were associated with poorer RFS (HR 1.18 [1.02-1.37], p = 0.031) but not OS (HR 1.05 [0.91-1.22], p = 0.48). Adjuvant and neoadjuvant treatments were infrequently used.Interpretation In this large, multicentre analysis of GBC surgical outcomes, liver resection was not conclusively associated with improved survival, and extended resections were associated with greater morbidity and mortality without oncological benefit. Aggressive upfront resections do not benefit higher stage GBC, and international col-laborations are needed to develop evidence-based neoadjuvant and adjuvant treatment strategies to minimise surgical morbidity and prioritise prognostic benefit.
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.openaccessGreen Published, Green Submitted
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.volume59
dc.identifier.doi10.1016/j.eclinm.2023.101951
dc.identifier.eissn2589-5370
dc.identifier.quartileQ1
dc.identifier.scopus2-s2.0-85152300811
dc.identifier.urihttps://doi.org/10.1016/j.eclinm.2023.101951
dc.identifier.urihttps://hdl.handle.net/20.500.14288/25593
dc.identifier.wos1043233100001
dc.keywordsGallbladder cancer
dc.keywordsLiver resection
dc.keywordsSurgical outcomes
dc.keywordsCholangiocarcinoma
dc.language.isoeng
dc.publisherElsevier
dc.relation.ispartofEclinicalmedicine
dc.subjectMedicine, general and internal
dc.titleSurgical outcomes of gallbladder cancer: the OMEGA retrospective, multicentre, international cohort study
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorAdsay, Nazmi Volkan
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit1KUH (KOÇ UNIVERSITY HOSPITAL)
local.publication.orgunit2KUH (Koç University Hospital)
local.publication.orgunit2School of Medicine
relation.isOrgUnitOfPublicationf91d21f0-6b13-46ce-939a-db68e4c8d2ab
relation.isOrgUnitOfPublicationd02929e1-2a70-44f0-ae17-7819f587bedd
relation.isOrgUnitOfPublication.latestForDiscoveryf91d21f0-6b13-46ce-939a-db68e4c8d2ab
relation.isParentOrgUnitOfPublication055775c9-9efe-43ec-814f-f6d771fa6dee
relation.isParentOrgUnitOfPublication17f2dc8e-6e54-4fa8-b5e0-d6415123a93e
relation.isParentOrgUnitOfPublication.latestForDiscovery055775c9-9efe-43ec-814f-f6d771fa6dee

Files

Original bundle

Now showing 1 - 1 of 1
Thumbnail Image
Name:
IR05550.pdf
Size:
1.53 MB
Format:
Adobe Portable Document Format