Systematic review and meta-analysis of survival outcomes in T2a and T2b gallbladder cancers

Wasfi Alrawashdeh; Sivesh K. Kamarajah; Rohan R. Gujjuri; William A. Cambridge; Shailesh V. Shrikhande; Alice C. Wei; Mohamed Abu Hilal; Steve A. White; Sanjay Pandanaboyana

doi:10.1016/j.hpb.2021.12.019

Systematic review and meta-analysis of survival outcomes in T2a and T2b gallbladder cancers

Wasfi Alrawashdeh^*, Sivesh K. Kamarajah, Rohan R. Gujjuri, William A. Cambridge, Shailesh V. Shrikhande, Alice C. Wei, Mohamed Abu Hilal, Steve A. White, Sanjay Pandanaboyana

^*Corresponding author for this work

Applied Health Sciences

Research output: Contribution to journal › Review article › peer-review

Abstract

Background: The 8th edition of AJCC TNM staging of Gallbladder cancer subdivided T2 stage into T2a and T2b based on tumour location. This meta-analysis aimed to investigate the long-term outcomes in T2a and T2b gallbladder cancers.

Methods: Literature search of Medline, Web of science, Embase and Cochrane databases was performed. Study characteristics, survival and recurrence data were extracted for meta-analysis of effect estimates and of individual patient data.

Results: Fifteen retrospective studies (2531 patients, T2a = 1332, T2b = 199) were included in the meta-analysis. Overall survival (OS) was significantly worse in patients with T2b compared to T2a tumours (HR 2.18, 95% CI 1.67–2.86, p < 0.0001). Meta-analysis of individual patient data (n = 629) showed similar results (HR 1.92, 95% CI 1.43–2.58, p < 0.00001). Patients with T2b tumours had higher risk of recurrence compared to T2a (OR 3.19, 95% CI 1.40–7.28, p = 0.006) and were more likely to receive adjuvant chemotherapy (OR 1.76, 95% CI 1.12–2.84, p = 0.014). Liver resection improved OS in T2b tumours (HR 2.99, CI 1.73–5.16, p < 0.0001).

Conclusion: T2b gallbladder tumours have worse overall survival and increase risk of recurrence compared to T2a. Liver resection appears to improve OS in patients with T2b tumours. However, high quality multicenter data is required to confirm these results.

Original language	English
Pages (from-to)	789-796
Number of pages	8
Journal	HPB
Volume	24
Issue number	6
Early online date	30 May 2022
DOIs	https://doi.org/10.1016/j.hpb.2021.12.019
Publication status	Published - Jun 2022

Bibliographical note

Publisher Copyright:
© 2021 International Hepato-Pancreato-Biliary Association Inc.

ASJC Scopus subject areas

Hepatology
Gastroenterology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.hpb.2021.12.019

Cite this

@article{b07dacc5edd34856a0c5ad7570ca375c,

title = "Systematic review and meta-analysis of survival outcomes in T2a and T2b gallbladder cancers",

abstract = "Background: The 8th edition of AJCC TNM staging of Gallbladder cancer subdivided T2 stage into T2a and T2b based on tumour location. This meta-analysis aimed to investigate the long-term outcomes in T2a and T2b gallbladder cancers.Methods: Literature search of Medline, Web of science, Embase and Cochrane databases was performed. Study characteristics, survival and recurrence data were extracted for meta-analysis of effect estimates and of individual patient data.Results: Fifteen retrospective studies (2531 patients, T2a = 1332, T2b = 199) were included in the meta-analysis. Overall survival (OS) was significantly worse in patients with T2b compared to T2a tumours (HR 2.18, 95% CI 1.67–2.86, p < 0.0001). Meta-analysis of individual patient data (n = 629) showed similar results (HR 1.92, 95% CI 1.43–2.58, p < 0.00001). Patients with T2b tumours had higher risk of recurrence compared to T2a (OR 3.19, 95% CI 1.40–7.28, p = 0.006) and were more likely to receive adjuvant chemotherapy (OR 1.76, 95% CI 1.12–2.84, p = 0.014). Liver resection improved OS in T2b tumours (HR 2.99, CI 1.73–5.16, p < 0.0001).Conclusion: T2b gallbladder tumours have worse overall survival and increase risk of recurrence compared to T2a. Liver resection appears to improve OS in patients with T2b tumours. However, high quality multicenter data is required to confirm these results.",

author = "Wasfi Alrawashdeh and Kamarajah, {Sivesh K.} and Gujjuri, {Rohan R.} and Cambridge, {William A.} and Shrikhande, {Shailesh V.} and Wei, {Alice C.} and {Abu Hilal}, Mohamed and White, {Steve A.} and Sanjay Pandanaboyana",

note = "Publisher Copyright: {\textcopyright} 2021 International Hepato-Pancreato-Biliary Association Inc.",

year = "2022",

month = jun,

doi = "10.1016/j.hpb.2021.12.019",

language = "English",

volume = "24",

pages = "789--796",

journal = "HPB",

issn = "1365-182X",

publisher = "Wiley",

number = "6",

}

TY - JOUR

T1 - Systematic review and meta-analysis of survival outcomes in T2a and T2b gallbladder cancers

AU - Alrawashdeh, Wasfi

AU - Kamarajah, Sivesh K.

AU - Gujjuri, Rohan R.

AU - Cambridge, William A.

AU - Shrikhande, Shailesh V.

AU - Wei, Alice C.

AU - Abu Hilal, Mohamed

AU - White, Steve A.

AU - Pandanaboyana, Sanjay

PY - 2022/6

Y1 - 2022/6

N2 - Background: The 8th edition of AJCC TNM staging of Gallbladder cancer subdivided T2 stage into T2a and T2b based on tumour location. This meta-analysis aimed to investigate the long-term outcomes in T2a and T2b gallbladder cancers.Methods: Literature search of Medline, Web of science, Embase and Cochrane databases was performed. Study characteristics, survival and recurrence data were extracted for meta-analysis of effect estimates and of individual patient data.Results: Fifteen retrospective studies (2531 patients, T2a = 1332, T2b = 199) were included in the meta-analysis. Overall survival (OS) was significantly worse in patients with T2b compared to T2a tumours (HR 2.18, 95% CI 1.67–2.86, p < 0.0001). Meta-analysis of individual patient data (n = 629) showed similar results (HR 1.92, 95% CI 1.43–2.58, p < 0.00001). Patients with T2b tumours had higher risk of recurrence compared to T2a (OR 3.19, 95% CI 1.40–7.28, p = 0.006) and were more likely to receive adjuvant chemotherapy (OR 1.76, 95% CI 1.12–2.84, p = 0.014). Liver resection improved OS in T2b tumours (HR 2.99, CI 1.73–5.16, p < 0.0001).Conclusion: T2b gallbladder tumours have worse overall survival and increase risk of recurrence compared to T2a. Liver resection appears to improve OS in patients with T2b tumours. However, high quality multicenter data is required to confirm these results.

AB - Background: The 8th edition of AJCC TNM staging of Gallbladder cancer subdivided T2 stage into T2a and T2b based on tumour location. This meta-analysis aimed to investigate the long-term outcomes in T2a and T2b gallbladder cancers.Methods: Literature search of Medline, Web of science, Embase and Cochrane databases was performed. Study characteristics, survival and recurrence data were extracted for meta-analysis of effect estimates and of individual patient data.Results: Fifteen retrospective studies (2531 patients, T2a = 1332, T2b = 199) were included in the meta-analysis. Overall survival (OS) was significantly worse in patients with T2b compared to T2a tumours (HR 2.18, 95% CI 1.67–2.86, p < 0.0001). Meta-analysis of individual patient data (n = 629) showed similar results (HR 1.92, 95% CI 1.43–2.58, p < 0.00001). Patients with T2b tumours had higher risk of recurrence compared to T2a (OR 3.19, 95% CI 1.40–7.28, p = 0.006) and were more likely to receive adjuvant chemotherapy (OR 1.76, 95% CI 1.12–2.84, p = 0.014). Liver resection improved OS in T2b tumours (HR 2.99, CI 1.73–5.16, p < 0.0001).Conclusion: T2b gallbladder tumours have worse overall survival and increase risk of recurrence compared to T2a. Liver resection appears to improve OS in patients with T2b tumours. However, high quality multicenter data is required to confirm these results.

UR - http://www.scopus.com/inward/record.url?scp=85122936418&partnerID=8YFLogxK

U2 - 10.1016/j.hpb.2021.12.019

DO - 10.1016/j.hpb.2021.12.019

M3 - Review article

C2 - 35042673

AN - SCOPUS:85122936418

SN - 1365-182X

VL - 24

SP - 789

EP - 796

JO - HPB

JF - HPB

IS - 6

ER -