{Reference Type}: Clinical Trial
{Title}: The significance of anatomic tumor location in gallbladder cancer.
{Author}: Leigh N;Pletcher E;Solomon D;Sarpel U;Labow DM;Magge DR;Golas BJ;
{Journal}: J Surg Oncol
{Volume}: 123
{Issue}: 4
{Year}: Mar 2021
{Factor}: 2.885
{DOI}: 10.1002/jso.26345
{Abstract}: <B>OBJECTIVE: </B>Current management guidelines recognize the impact of hepatic versus peritoneal sided gallbladder cancers (GBC) on survival. However, no data exist regarding the significance of anatomic tumor location within the gallbladder.<BR><B>METHODS: </B>We retrospectively analyzed all GBC that underwent surgical resection with curative intent in our health system from 2007 to 2017. We evaluated the effect of anatomic pathologic tumor location (fundus/body, neck, and multifocal) on clinicopathologic, perioperative, and oncologic outcomes.<BR><B>RESULTS: </B>About 97 patients met criteria; 63% fundus/body, 22% multifocal, and 15% neck. Compared with fundus/body, neck tumors more frequently presented with preoperative jaundice (53% vs. 13%, p < .001), were smaller (20 mm vs. 30 mm, p = .068) and had significantly more biliary tree invasion (33% vs. 13%, p = .030) on histopathology. Although tumor characteristics (pTNM stage, liver invasion, lymphovascular invasion, prognostic nutritional index, and grade) were similar, neck tumors had significantly higher rates of R0 resection (53% vs. 11%, p < .001). Rates of adjuvant therapy were similar. Median PFS was similar between cohorts (p = .356). However, median overall survival (OS) was significantly shorter in neck (21 months) than fundus/body tumors (NR > 109 months), p = .015.<BR><B>CONCLUSIONS: </B>Neck tumors were rare, small and more likely to result in jaundice secondary to biliary tree invasion. Despite higher R0 resection rates, these tumors had significantly worse OS.