Publications

Authors:

Serenari, Matteo; Berti, Davide; Rivera, Belen; Newhook, Timothy E; Kristjanpoller, Werner; Ruzzenente, Andrea; Okuno, Masayuki; De Bellis, Mario; Panettieri, Elena; Ahmad, M Usman; Merlo, Ignacio; De Rose, Agostino Maria; Nishino, Hiroto; Sinnamon, Andrew J; Donadon, Matteo; Hauger, Marit S; Guevara, Oscar M; Munoz, Cesar; Denbo, Jason; Chun, Yun Shin; Tran Cao, Hop S; Sanchez Claria, Rodrigo; Tzeng, Ching-Wei D; De Aretxabala, Xabier; Vivanco, Marcelo; Brudvik, Kristoffer W; Seo, Satoru; Pekolj, Juan; Poultsides, George A; Anaya, Daniel A; Torzilli, Guido; Giuliante, Felice; Guglielmi, Alfredo; Vinuela, Eduardo; Vauthey, Jean-Nicolas; Cescon, Matteo; Vega, Eduardo A

Title:

Optimizing Outcomes in Gallbladder Cancer: Identifying Predictors of Futile Up-Front Surgery in a Global Multi-center Study

Year:

2025

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Referee:

No

Name of journal:

ANNALS OF SURGICAL ONCOLOGY

ISSN of journal:

1068-9265

Page numbers:

1-9

Keyword:

Gallbladder cancer, liver resection, surgery

Short description of contents:

BackgroundGallbladder cancer (GBC) has a poor prognosis, particularly in advanced stages, with surgery often offering limited survival benefit. This study aimed to identify risk factors for futile surgery (FS), defined as procedures followed by early recurrence or death.MethodsAn international cohort of 788 patients who underwent up-front GBC surgery across 18 centers was analyzed. Futility was defined as recurrence within 5 months or death within 90 days after oncological surgery. A multivariate model was built, and an online calculator was developed to predict the probability of FS.ResultsA total of 107 patients (13.6%) experienced FS, with a median survival of only 6.8 months, compared with 57.4 months for nonfutile cases. The key risk factors identified were the T3-T4 tumor stage (odds ratio [OR] 2.20; 95% confidence interval [CI] 1.30-3.71), lymph node involvement (OR 1.91; 95% CI 1.22-2.98), and multivisceral resection (OR 2.25; 95% CI 1.28-3.94). Incidental GBC diagnoses showed a lower risk of FS (OR 0.41; 95% CI 0.25-0.67). The predictive model had a strong discriminative ability (c-statistic: 0.749). Decision curve analysis demonstrated the superiority of the multivariate model over individual predictors.ConclusionsRefining patient selection can reduce futile surgeries in GBC. The predictive model provides a valuable online tool (https://aicep.website/?cff-form=25) to improve decision-making and outcomes by minimizing unnecessary interventions.

Product ID:

144708

Handle IRIS:

11562/1157569

Last Modified:

March 17, 2025

Bibliographic citation:

Serenari, Matteo; Berti, Davide; Rivera, Belen; Newhook, Timothy E; Kristjanpoller, Werner; Ruzzenente, Andrea; Okuno, Masayuki; De Bellis, Mario; Panettieri, Elena; Ahmad, M Usman; Merlo, Ignacio; De Rose, Agostino Maria; Nishino, Hiroto; Sinnamon, Andrew J; Donadon, Matteo; Hauger, Marit S; Guevara, Oscar M; Munoz, Cesar; Denbo, Jason; Chun, Yun Shin; Tran Cao, Hop S; Sanchez Claria, Rodrigo; Tzeng, Ching-Wei D; De Aretxabala, Xabier; Vivanco, Marcelo; Brudvik, Kristoffer W; Seo, Satoru; Pekolj, Juan; Poultsides, George A; Anaya, Daniel A; Torzilli, Guido; Giuliante, Felice; Guglielmi, Alfredo; Vinuela, Eduardo; Vauthey, Jean-Nicolas; Cescon, Matteo; Vega, Eduardo A, Optimizing Outcomes in Gallbladder Cancer: Identifying Predictors of Futile Up-Front Surgery in a Global Multi-center Study «ANNALS OF SURGICAL ONCOLOGY» , 2025 , pp. 1-9

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