What question did this study set out to answer?

To evaluate factors associated with recurrence-free survival, overall survival, and postoperative morbidity and mortality following gallbladder cancer surgery across high-income and low- and middle-income countries.

April 13, 2023EClinicalMedicineOpen Access

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

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To evaluate factors associated with recurrence-free survival, overall survival, and postoperative morbidity and mortality following gallbladder cancer surgery across high-income and low- and middle-income countries.
International, retrospective multicentre cohort study (OMEGA) analyzing N=3,676 patients who underwent surgical resection for gallbladder cancer across 133 centres between January 1, 2010, and December 31, 2020.
Multivariable regression models evaluated the associations of surgical extents (wedge resection, segment IVb/V resection, major hepatectomy, extrahepatic bile duct resection), organ resections, and country income status with oncologic and safety outcomes.
Liver resection failed to confer oncological benefit: wedge resection did not improve recurrence-free survival (HR 1.04 [95% CI, 0.84–1.29], p=0.711) or overall survival (HR 0.96 [0.79–1.17], p=0.67), segment IVb/V resection did not improve recurrence-free survival (HR 1.18 [0.95–1.46], p=0.13) or overall survival (HR 1.48 [1.16–1.88], p=0.49), and major hepatectomy worsened recurrence-free survival (HR 1.33 [1.02–1.74], p=0.037) and overall survival (HR 1.26 [1.03–1.53], p=0.022).
Morbidity and mortality significantly increased with extrahepatic bile duct resection (OR 2.86 [95% CI, 2.30–3.52], p<0.0010), additional organ resection (OR 2.22 [1.62–3.02], p<0.0010), and major hepatectomy (OR 3.81 [2.55–5.73], p<0.0010).
Patients treated in high-income countries had worse recurrence-free survival than those in low- and middle-income countries (HR 1.18 [95% CI, 1.02–1.37], p=0.031), with no significant difference in overall survival (HR 1.05 [0.91–1.22], p=0.48).

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Implication

Retrospective cohort study reveals extended surgical resection does not improve survival in gallbladder cancer, indicating more aggressive procedures increase morbidity without oncological benefit.

Cite This Study

Balakrishnan et al. (2023) studied this question.

synapsesocial.com/papers/6a7efa70e7861671be8ed287 https://doi.org/10.1016/j.eclinm.2023.101951

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Implication

Retrospective cohort study reveals extended surgical resection does not improve survival in gallbladder cancer, indicating more aggressive procedures increase morbidity without oncological benefit.

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

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Discussion

Implication

Cite This Study

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

Key Points

Discussion

Implication

Cite This Study

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