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Adam KM, Abdelrahim EY, Doush WM, Abdelaziz MS. Clinical presentation and management modalities of gallbladder cancer in Sudan: A single-center study. JGH Open 2023; 7:365-371. [PMID: 37265936 PMCID: PMC10230110 DOI: 10.1002/jgh3.12906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 04/11/2023] [Indexed: 06/03/2023]
Abstract
Background and Aim Gallbladder cancer (GBC) is a rare and highly aggressive malignancy characterized by late presentation of nonspecific symptoms, poor curability, and high mortality. The gold standard for effective treatment depends on early detection and surgical excision. Hence, the aim of this study was to determine the patterns of clinical presentation and management modalities to reach excellent practice. Methods A retrospective study was conducted during the period from May 2021 to April 2022 at Ibn Sina specialized hospital, Khartoum, Sudan, on 50 patients with GBC who underwent a preoperative clinical and radiological evaluation to enable the use of appropriate surgical and oncological approaches. Results GBC was more prevalent in females in this series where all had GBC (68%), in the ratio 2:1. Distribution of patients according to age ranged between 61 and 75 years, representing 44% of patients. Abdominal pain, nausea, and vomiting were present in 40% of patients. Fifty-six percent of patients resided in urban areas. Transabdominal ultrasound (TUS) with CT scan diagnosed GBC in 54% of patients. GBC was metastatic (stage IV) in 52% of patients. Based on preoperative decision by a multidisciplinary team (MDT), 62% of patients had palliative nonsurgical oncological treatment. Histopathological analysis of the resected GBC showed adenocarcinoma in 74% of cases. The inoperable patients (42%) were treated palliativelly with endoscopic retrograde cholangiopancreatography/systemic chemotherapy. Finally, the overall mortality rate was 56%. Conclusions Accurate early clinical diagnosis and advanced radiological modalities with curative surgical approaches including clear surgical resection margins and systemic oncological therapies will potentially help in improving GBC survival outcomes.
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Affiliation(s)
- Khatab M. Adam
- Department of Gastroenterological SurgeryIbn Sina Specialized HospitalKhartoumSudan
| | | | - Wael Mohialddin Doush
- Department of Gastroenterological SurgeryIbn Sina Specialized HospitalKhartoumSudan
- Department of Surgery, Faculty of Medicine and Health SciencesOmdurman Islamic UniversityKhartoumSudan
| | - Muataz S. Abdelaziz
- Department of Surgery, Faculty of Medicine and Health SciencesOmdurman Islamic UniversityKhartoumSudan
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Liu S, Zhang L, Guan XE, Zhang L, Wang R. Target nursing care on anxiety and depression in patients with gallbladder cancer during perioperative period. Medicine (Baltimore) 2022; 101:e29883. [PMID: 35945715 PMCID: PMC9351855 DOI: 10.1097/md.0000000000029883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND This study retrospectively investigated the effects of target nursing care (TNC) on anxiety and depression in patients with gallbladder cancer (GBC) during the perioperative period. METHODS This retrospective study analyzed the data of 80 patients with GBC during perioperative period. These records were divided into an intervention group (n = 40) or a control group (n = 40). All 80 patient records in both groups were administered routine nursing care (RNC). The patients in the intervention group also underwent TNC. The primary outcomes were depression (measured using the Hamilton Depression Scale, HAMD) and anxiety (assessed using the Hamilton Anxiety Scale, HAMA). The secondary outcomes were quality of life (assessed using the 36-Item Short Form Health Survey, SF-36) and adverse events. We collected and analyzed the outcome data before and after treatment. RESULTS After treatment, patients in the intervention group showed more promising effects on depression (HAMD, P < .01) and anxiety (HAMA, P < .01) than those in the control group did. However, there were no significant differences in the quality of life before and after treatment. No TNC- or RNC-associated adverse events were reported in patient records. CONCLUSION This study found that TNC was more effective than RNC in relieving depression and anxiety. Future studies should be conducted to validate the present findings.
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Affiliation(s)
- Shuang Liu
- Cardiac Intensive Care Unit, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, China
| | - Li Zhang
- Department of Scientific Research, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, China
| | - Xiu-e Guan
- Department of Oncology, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, China
| | - Lei Zhang
- Dialysis Unit, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, China
| | - Rui Wang
- First Ward of General Surgery Department, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, China
- *Correspondence: Rui Wang, MB, First Ward of General Surgery Department, Hongqi Hospital Affiliated to Mudanjiang Medical University, No.5 Tongxiang Street, Aimin District, Mudanjiang, 157011, China (e-mail: )
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Akhtar-Danesh N, Akhtar-Danseh GG, Seow H, Shakeel S, Finley C. Treatment Modality and Trends in Survival for Gallbladder Cancer: a Population-Based Study. J Gastrointest Cancer 2021; 52:256-262. [PMID: 32185744 DOI: 10.1007/s12029-020-00397-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE There are only a few reports on the treatment-based survival of gallbladder cancer (GBC). The primary objective of this study was to examine the change in treatment modality and the related trends in the survival of GBC. METHODS This study includes all cases of primary GBC diagnosed in the province of Ontario, Canada, from January 2007 to December 2015 with known disease stage. Treatment modalities were classified as no treatment, radiation or chemotherapy, and surgical resection. We examined the association between surgical resection and demographics and tumor characteristics and estimated the trends in survival based on treatment modality. RESULTS In total, 564 patients with GBC were identified, of which 374 (66.3%) were female. Although there were no significant trends in treatment modalities over the study period (p = 0.276), survival rates improved for all treatment modalities over time. There was a 35% increase in 5-year survival for the surgical resection group from 2007 to 2015. For patients with stage I-II disease, the 5-year survival rate increased 40% over time. The highest 5-year survival was observed for the surgical resection group in patients with stage I-II disease (0.533 (95% CI, 0.514-0.552)) while the average 5-year survival rate for all patients over the study period was 0.247 (95% CI, 0.228-0.266). CONCLUSIONS Most cases of GBC continue to be diagnosed in the late stage. Five-year survival for the surgical resection group has markedly improved over time, specifically for patients with stage I-II disease which increased from 30% in 2007 to 70% in 2015.
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Affiliation(s)
- Noori Akhtar-Danesh
- School of Nursing, McMaster University, 1280 Main St. West, Room 3N28B, Hamilton, ON, l8S 4K1, Canada. .,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
| | | | - Hsien Seow
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.,Department of Oncology, McMaster University, Hamilton, Canada
| | - Saad Shakeel
- School of Medicine, University of Toronto, Toronto, Canada
| | - Christian Finley
- Division of Thoracic Surgery, Department of Surgery, McMaster University, Hamilton, Canada
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Naveed S, Qari H, Thau CM, Burasakarn P, Mir AW, Panday BB. Lymph Node Ratio is an Important Prognostic Factor in Curatively Resected Gallbladder Carcinoma, Especially in Node-positive Patients: An Experience from Endemic Region in a Developing Country. Euroasian J Hepatogastroenterol 2021; 11:1-5. [PMID: 34316456 PMCID: PMC8286361 DOI: 10.5005/jp-journals-10018-1336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Metastasis to lymph nodes is a bad prognostic factor in patients with gallbladder carcinoma who undergo radical cholecystectomy. During the past decade, studies have brought focus on lymph node ratio (LNR) as an additional valuable prognostic factor in these cases.Our research studied the factors that predicted the recurrence of disease and survival of patients with gallbladder carcinoma who were treated with surgical resection, concentrating especially on the lymph nodal status as a prognostic factor and LNR in node-positive T1-T3 cases. Methods In our hospital, Mahavir Cancer Institute and Research Centre, we reviewed retrospective data, from 2009 to 2014, of 60 patients who had undergone radical cholecystectomy for gallbladder carcinoma. We staged the patients as per the AJCC eight edition. Predictive factors that affect disease-free survival (DFS), like age, gender, postoperative complications, lymphovascular invasion (LVI) and perineural invasion (PVI), lymph node dissection, differentiation, T stage, N stage, number of lymph nodes involved, and LNR, were examined statistically. Results Lymph nodal involvement was found to be a principal predictive factor in cases in whom radical cholecystectomy was done. The number of lymph nodes dissected determined the prognosis in N0 cases. LNR was a strong prognostic factor for DFS in cases of curatively resected gallbladder cancer. Conclusion LNR is a strong predictive factor in radically resected gallbladder carcinoma cases. How to cite this article Naveed S, Qari H, Thau CM, et al. Lymph Node Ratio is an Important Prognostic Factor in Curatively Resected Gallbladder Carcinoma, Especially in Node-positive Patients: An Experience from Endemic Region in a Developing Country. Euroasian J Hepato-Gastroenterol 2021;11(1):1-5.
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Affiliation(s)
- Shah Naveed
- Department of Surgical Oncology, Upper GI and HPB Oncosurgery, SKIMS, Srinagar, Jammu and Kashmir, India
| | - Hasina Qari
- Department of Health and Family Welfare, Jammu and Kashmir, India
| | - Cao M Thau
- HPB Division, Institute of Gastroenterology, Tokyo Womens Medical University Hospital, Tokyo, Japan
| | - Pipit Burasakarn
- Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand
| | - Abdul W Mir
- Department of Surgical Oncology, SKIMS, Srinagar, Jammu and Kashmir, India
| | - Brij Bhushan Panday
- Department of Surgical Oncology, Mahavir Cancer Sansthan, Patna, Bihar, India
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Zhou J, Gao F, Zhang H, Xing M, Xu Z, Zhang R. MiR-520b inhibits proliferation, migration and invasion in gallbladder carcinoma by targeting RAB22A. Arch Med Sci 2021; 17:481-491. [PMID: 33747283 PMCID: PMC7959058 DOI: 10.5114/aoms.2019.89650] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 02/04/2019] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Previous studies have reported that miR-520b exhibited inhibitory effects on various human tumors, whereas the effects of miR-520b on gallbladder carcinoma (GBC) have remained unclear. To investigate the effects of miR-520b on GBC progression and reveal the underlying mechanisms, this study was performed. MATERIAL AND METHODS MiR-520b and RAB22A mRNA levels were analyzed by quantitative real-time PCR (qPCR). RAB22A protein level was analyzed via Western blot and immunohistochemical (IHC) analysis. The proliferation, colony formation ability, migration and invasion of NOZ cells were measured via MTT, colony formation, wound healing and transwell invasion assay respectively. RESULTS MiR-520b expression level was lower in human GBC tissues than that in neighboring normal tissues. MiR-520b mimic repressed NOZ cell proliferation, colony formation ability, migration and invasion, whereas miR-520b inhibitor exhibited opposite effects. Dual luciferase reporter assay confirmed that miR-520b could bind to the 3'-untranslated regions of RAB22A mRNA. Moreover, RAB22A overexpression significantly abolished the anti-tumor effects of miR-520b in a NOZ cell model. Western blot, qPCR and IHC analysis proved that human GBC tissues showed a higher RAB22A expression level than neighboring normal tissues. Additionally, there was a negative association between miR-520b and RAB22A expression. CONCLUSIONS MiR-520b had suppressive effects on GBC via targeting RAB22A in vitro.
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Affiliation(s)
- Jianpeng Zhou
- Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Feng Gao
- Department of Gastrointestinal Surgery, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Hua Zhang
- Department of Gastrointestinal Surgery, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Mingxuan Xing
- Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun, Jilin, China
| | - Zining Xu
- Norman Bethune Health Science Center of Jilin University, Changchun, Jilin, China
| | - Ruoyan Zhang
- Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun, Jilin, China
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Li J, Sun Y, Zhao B, Tang C, Fan D, Jiang W, Rixiati Y. Lymph Node Ratio-Based Staging System for Gallbladder Cancer With Fewer Than Six Lymph Nodes Examined. Front Oncol 2020; 10:542005. [PMID: 33102214 PMCID: PMC7546035 DOI: 10.3389/fonc.2020.542005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 08/27/2020] [Indexed: 12/26/2022] Open
Abstract
Purpose The 8th edition of the American Joint Committee on Cancer (AJCC) tumor-lymph node-metastasis (TNM) staging system for gallbladder cancer (GBC) recommended that at least six lymph nodes (LNs) should be examined. But most patients with GBC had fewer than six LNs resected. This study aimed to establish an alternative index for assessing the LN status during the staging system for GBC patients with fewer than six LNs retrieved. Patients and Methods Patient data was extracted from the Surveillance, Epidemiology, and End Results (SEER) database (cases between 2004 and 2013). X-tile software was used to determine the optimal cutoff value for lymph node ratio (LNR) and a concordance index (C-index) was used to evaluate the discriminatory powers of the two staging systems. Results The majority of GBC patients in our cohort (1353, 78.5%) had fewer than six LNs examined. Among patients with inadequate LN examination, the higher number of LNs examined correlated with a lower proportion of patients. Using the TNM staging system, the C-index for patients with fewer than six LNs and patients with six or more LNs screened were 0.636 and 0.704, respectively. Using the staging system based on LNR (TNrM), the C-index for patients with fewer than six LNs retrieved and patients with six or more LNs retrieved were 0.649 and 0.694, respectively. Similar results were observed in patients with gallbladder adenocarcinoma (GBA). Conclusion TNrM might be superior to the 8th AJCC TNM staging system for stratifying GBC patients with fewer than six LNs examined, and it can complement TNM for more accurate risk stratification. Future prospective studies are needed to validate our findings.
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Affiliation(s)
- Jinjun Li
- Department of Surgery, Tianjin Second People's Hospital, Tianjin, China
| | - Yao Sun
- Vascular Surgery Department, First Affiliated Hospital of Jiamusi University, Jiamusi, China
| | - Bingqing Zhao
- Department of Surgery, Tianjin Second People's Hospital, Tianjin, China
| | - Chuangang Tang
- Department of Breast Surgery, Xuzhou Central Hospital, The Affiliated Xuzhou Hospital of Medical College of Southeast University, Xuzhou, China
| | - Dongxu Fan
- Vascular Surgery Department, First Affiliated Hospital of Jiamusi University, Jiamusi, China
| | - Wenli Jiang
- Department of Biochemistry and Molecular Biology, College of Basic Medical, Navy Medical University, Shanghai, China
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Yuan B, Fu J, Yu WL, Fu XH, Qiu YH, Yin L, Zhu B, Zhang YJ. Prognostic value of serum high-density lipoprotein cholesterol in patients with gallbladder cancer. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2020; 111:839-845. [PMID: 31595756 DOI: 10.17235/reed.2019.6201/2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES the aim of this study was to evaluate the prognostic significance of preoperative serum lipid in patients with gallbladder cancer (GBC). METHODS ninety-nine patients with GBC between October 2009 and December 2013 were reviewed in this retrospective study. Total serum cholesterol (TC), total triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein A (Apo-A), apolipoprotein B (Apo-B) and free fatty acids (FFA) were measured before surgery. The correlation of serum lipid levels with clinical data, including gender, age, tumor size, lymph nodes metastasis, tumor differentiation, distant metastasis and TNM stage were analyzed by univariate and multivariate survival analysis to evaluate independent prognostic factors. RESULTS compared with the normal HDL-C group (n = 57), the overall survival rate among GBC patients with low HDL-C levels (n = 42) was reduced (p < 0.05). However, there were no significant differences in overall survival for patients with different levels of TC, TG, Apo-A, Apo-B, LDL-C or FFA. The serum level of HDL-C was associated with TNM stage (p < 0.05) and distant metastasis (p < 0.001). The multivariate prognosis analysis showed that HDL-C and lymph nodes metastasis were independent prognostic factors (p < 0.05). A prognostic evaluation model based on HDL-C and lymph nodes metastasis was established. CONCLUSION preoperative serum HDL-C level was closely associated with distant metastasis of patients with GBC. HDL-C level may be a valuable prognostic factor for GBC patients. The combination of HDLC and lymph nodes metastasis can better predict the prognosis of GBC.
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Affiliation(s)
- Bo Yuan
- Second Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University,
| | - Jing Fu
- National Center for Liver Cancer, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University
| | - Wen-Long Yu
- Second Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University
| | - Xiao-Hui Fu
- Second Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University,
| | - Ying-He Qiu
- Second Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University,
| | - Lei Yin
- Second Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University,
| | - Bin Zhu
- Second Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University,
| | - Yong-Jie Zhang
- Second Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Mil, China
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