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Surgical Indication for Advanced Gallbladder Cancer Considering the Optimal Preoperative Carbohydrate Antigen 19-9 Cutoff Value.
Dig Surg. 2020; 37(5):390-400.DS

Abstract

BACKGROUND

Selecting patients who will benefit from resection among those with advanced gallbladder cancer (GBCa) having poor prognostic factors is difficult.

METHODS

One hundred twenty-one patients who underwent resection for stage II-IV GBCa and 19 unresected patients (unresectable group) were enrolled. The clinical impact of carbohydrate antigen 19-9 (CA19-9) and advanced surgical procedures for GBCa was evaluated.

RESULTS

The optimal CA19-9 cutoff value (based on the greatest difference in overall survival) was 250 U/mL. CA19-9 ≥250 U/mL was found to be an independent prognostic factor. Patients with CA19-9 <250 U/mL who developed jaundice (median survival time [MST], 49.1 months) or who required major hepatectomy (MST, 21.5 months) or pancreatoduodenectomy (PD; MST, 50.3 months) had a better prognosis than those with CA19-9 ≥250 U/mL who developed jaundice (MST, 16.1 months; p = 0.061) or who required major hepatectomy (MST, 9.2 months; p = 0.066) or PD (MST, 8.6 months; p = 0.025); their prognosis was comparable to that of the unresectable group (jaundice: p = 0.145, major hepatectomy: p = 0.292, PD: p = 0.756).

CONCLUSIONS

Even if GBCa patients develop jaundice or require major hepatectomy, or combined PD, resection can be considered for those with CA19-9 <250 U/mL. However, surgical indication should be carefully determined in patients with CA19-9 ≥250 U/mL.

Authors+Show Affiliations

Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Nagaizumi, Japan, yusu.yamamoto@scchr.jp.Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Nagaizumi, Japan.Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Nagaizumi, Japan.Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Nagaizumi, Japan.Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Nagaizumi, Japan.Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Nagaizumi, Japan.Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Nagaizumi, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32272472

Citation

Yamamoto, Yusuke, et al. "Surgical Indication for Advanced Gallbladder Cancer Considering the Optimal Preoperative Carbohydrate Antigen 19-9 Cutoff Value." Digestive Surgery, vol. 37, no. 5, 2020, pp. 390-400.
Yamamoto Y, Sugiura T, Okamura Y, et al. Surgical Indication for Advanced Gallbladder Cancer Considering the Optimal Preoperative Carbohydrate Antigen 19-9 Cutoff Value. Dig Surg. 2020;37(5):390-400.
Yamamoto, Y., Sugiura, T., Okamura, Y., Ito, T., Ashida, R., Ohgi, K., & Uesaka, K. (2020). Surgical Indication for Advanced Gallbladder Cancer Considering the Optimal Preoperative Carbohydrate Antigen 19-9 Cutoff Value. Digestive Surgery, 37(5), 390-400. https://doi.org/10.1159/000506628
Yamamoto Y, et al. Surgical Indication for Advanced Gallbladder Cancer Considering the Optimal Preoperative Carbohydrate Antigen 19-9 Cutoff Value. Dig Surg. 2020;37(5):390-400. PubMed PMID: 32272472.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Surgical Indication for Advanced Gallbladder Cancer Considering the Optimal Preoperative Carbohydrate Antigen 19-9 Cutoff Value. AU - Yamamoto,Yusuke, AU - Sugiura,Teiichi, AU - Okamura,Yukiyasu, AU - Ito,Takaaki, AU - Ashida,Ryo, AU - Ohgi,Katsuhisa, AU - Uesaka,Katsuhiko, Y1 - 2020/04/09/ PY - 2019/11/09/received PY - 2020/02/18/accepted PY - 2020/4/10/pubmed PY - 2021/8/6/medline PY - 2020/4/10/entrez KW - Biliary surgery KW - Cancer of the gallbladder KW - Hepatobiliary surgery SP - 390 EP - 400 JF - Digestive surgery JO - Dig Surg VL - 37 IS - 5 N2 - BACKGROUND: Selecting patients who will benefit from resection among those with advanced gallbladder cancer (GBCa) having poor prognostic factors is difficult. METHODS: One hundred twenty-one patients who underwent resection for stage II-IV GBCa and 19 unresected patients (unresectable group) were enrolled. The clinical impact of carbohydrate antigen 19-9 (CA19-9) and advanced surgical procedures for GBCa was evaluated. RESULTS: The optimal CA19-9 cutoff value (based on the greatest difference in overall survival) was 250 U/mL. CA19-9 ≥250 U/mL was found to be an independent prognostic factor. Patients with CA19-9 <250 U/mL who developed jaundice (median survival time [MST], 49.1 months) or who required major hepatectomy (MST, 21.5 months) or pancreatoduodenectomy (PD; MST, 50.3 months) had a better prognosis than those with CA19-9 ≥250 U/mL who developed jaundice (MST, 16.1 months; p = 0.061) or who required major hepatectomy (MST, 9.2 months; p = 0.066) or PD (MST, 8.6 months; p = 0.025); their prognosis was comparable to that of the unresectable group (jaundice: p = 0.145, major hepatectomy: p = 0.292, PD: p = 0.756). CONCLUSIONS: Even if GBCa patients develop jaundice or require major hepatectomy, or combined PD, resection can be considered for those with CA19-9 <250 U/mL. However, surgical indication should be carefully determined in patients with CA19-9 ≥250 U/mL. SN - 1421-9883 UR - https://www.unboundmedicine.com/medline/citation/32272472/Surgical_Indication_for_Advanced_Gallbladder_Cancer_Considering_the_Optimal_Preoperative_Carbohydrate_Antigen_19_9_Cutoff_Value_ L2 - https://www.karger.com?DOI=10.1159/000506628 DB - PRIME DP - Unbound Medicine ER -