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Shin A, Cho S, Abe SK, Islam MR, Rahman MS, Saito E, Kazmi SZ, Katagiri R, Merritt M, Choi JY, Shu XO, Sawada N, Tamakoshi A, Koh WP, Sakata R, Hozawa A, Kim J, Park SK, Kweon SS, Wen W, Tsugane S, Kimura T, Yuan JM, Kanemura S, Sugawara Y, Shin MH, Ahsan H, Boffetta P, Chia KS, Matsuo K, Qiao YL, Rothman N, Zheng W, Inoue M, Kang D. Association of female reproductive and hormonal factors with gallbladder cancer risk in Asia: A pooled analysis of the Asia Cohort Consortium. Int J Cancer 2024; 155:240-250. [PMID: 38478921 PMCID: PMC11096000 DOI: 10.1002/ijc.34916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/18/2024] [Accepted: 01/22/2024] [Indexed: 05/16/2024]
Abstract
The female predominance of gallbladder cancer (GBC) has led to a hypothesis regarding the hormone-related aetiology of GBC. We aimed to investigate the association between female reproductive factors and GBC risk, considering birth cohorts of Asian women. We conducted a pooled analysis of 331,323 women from 12 cohorts across 4 countries (China, Japan, Korea, and Singapore) in the Asia Cohort Consortium. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) to assess the association between reproductive factors (age at menarche, parity, age at first delivery, breastfeeding, and age at menopause) and GBC risk. We observed that a later age at menarche was associated with an increased risk of GBC (HR 1.4, 95% CI 1.16-1.70 for 17 years and older vs. 13-14 years), especially among the cohort born in 1940 and later (HR 2.5, 95% CI 1.50-4.35). Among the cohort born before 1940, women with a later age at first delivery showed an increased risk of GBC (HR 1.56, 95% CI 1.08-2.24 for 31 years of age and older vs. 20 years of age and younger). Other reproductive factors did not show a clear association with GBC risk. Later ages at menarche and at first delivery were associated with a higher risk of GBC, and these associations varied by birth cohort.
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Affiliation(s)
- Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
- Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Republic of Korea
- Medical Research Centre, Genomic Medicine Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sooyoung Cho
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Medical Research Centre, Genomic Medicine Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sarah Krull Abe
- Division of Prevention, Centre for Public Health Sciences, National Cancer Centre Institute for Cancer Control, Tokyo, Japan
| | - Md Rashedul Islam
- Division of Prevention, Centre for Public Health Sciences, National Cancer Centre Institute for Cancer Control, Tokyo, Japan
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
| | - Md Shafiur Rahman
- Division of Prevention, Centre for Public Health Sciences, National Cancer Centre Institute for Cancer Control, Tokyo, Japan
- Research Centre for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Eiko Saito
- Institute for Global Health Policy Research, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Sayada Zartasha Kazmi
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ryoko Katagiri
- Division of Cohort Research, National Cancer Centre Institute for Cancer Control, Tokyo, Japan
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, Japan
| | - Melissa Merritt
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Ji-Yeob Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Xiao-Ou Shu
- Division of Epidemiology, Vanderbilt-Ingram Cancer Centre, Vanderbilt Epidemiology Centre, Vanderbilt University Medical Centre, Nashville, TN, USA
| | - Norie Sawada
- Division of Cohort Research, National Cancer Centre Institute for Cancer Control, Tokyo, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore
| | - Ritsu Sakata
- Radiation Effects Research Foundation, Hiroshima, Japan
| | - Atsushi Hozawa
- Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan
| | - Jeongseon Kim
- Graduate School of Science and Policy, National Cancer Centre, Goyang-si, Korea
| | - Sue K. Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
- Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Wanqing Wen
- Division of Epidemiology, Vanderbilt-Ingram Cancer Centre, Vanderbilt Epidemiology Centre, Vanderbilt University Medical Centre, Nashville, TN, USA
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Centre Institute for Cancer Control, Tokyo, Japan
- Graduate School of Public Health, International University of Health and Welfare, Tokyo, Japan
| | - Takashi Kimura
- Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Centre, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Seiki Kanemura
- Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan
| | - Yumi Sugawara
- Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Habibul Ahsan
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Paolo Boffetta
- Stony Brook Cancer Centre, Stony Brook University, Stony Brook, NY, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Kee Seng Chia
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Centre Research Institute, Nagoya, Japan
- Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - You-Lin Qiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Nathaniel Rothman
- Division of Cancer Epidemiology & Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Wei Zheng
- Division of Epidemiology, Vanderbilt-Ingram Cancer Centre, Vanderbilt Epidemiology Centre, Vanderbilt University Medical Centre, Nashville, TN, USA
| | - Manami Inoue
- Division of Prevention, Centre for Public Health Sciences, National Cancer Centre Institute for Cancer Control, Tokyo, Japan
| | - Daehee Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Republic of Korea
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Sakamoto M, Kumar A, Choudhary DK, Bishwapriya A, Ghosh A. Geo-spatial epidemiology of gallbladder cancer in Bihar, India. Sci Total Environ 2024; 928:172460. [PMID: 38615781 DOI: 10.1016/j.scitotenv.2024.172460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/16/2024]
Abstract
Recently, a substantial increase in gallbladder cancer (GBC) cases has been reported in Bihar, India. The region's groundwater can naturally contain harmful concentrations of arsenic, which appears to be epidemiologically linked to the unusually high incidence. However, the root causes remain largely unexplored. Recent findings of uranium in the state's groundwater may also have associations. This study investigates the geo-spatial epidemiology of GBC in Bihar, India-with a focus on the correlation between environmental carcinogens, particularly arsenic and uranium in groundwater, and the incidence of GBC. Utilizing data from 8460 GBC patients' registration records over an 11-year period at a single health center, the research employs Semi-parametric Geographically Weighted Poisson Regression (S-GWPR) to account for non-stationarity associations and explores significant factors contributing to GBC prevalence at a subdistrict level. The S-GWPR model outperformed the standard Poisson regression model. The estimates suggest that arsenic and uranium concentrations in groundwater did not present significant associations; however, this could be due to the lower resolution of this data at the district level, necessitating higher resolution data for accurate estimates. Other socio-environmental factors included demonstrated significant regional heterogeneity in their association with GBC prevalence. Notably, each 1 % increase in the coverage of well- and canal-irrigated areas is associated with a maximum of 3.0 % and 5.2 % rise in the GBC incidence rate, respectively, likely attributable to carcinogen exposure from irrigation water. Moreover, distance to the health center and domestic electricity connections appear to influence the number of reported GBC cases. The latter suggests that access to electricity might have facilitated the use of groundwater pumps-increasing exposure to carcinogens. The results underscore the necessity for targeted health policies and interventions based on fine-resolution spatial analysis, as well as ongoing environmental monitoring and research to better understand the multifaceted risk factors contributing to GBC.
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Affiliation(s)
- Maiko Sakamoto
- Department of International Studies, Graduate School of Frontier Sciences, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa, Chiba 2778563, Japan.
| | - Arun Kumar
- Mahavir Cancer Sansthan and Research Centre, Patna, Bihar 801505, India
| | | | | | - Ashok Ghosh
- Mahavir Cancer Sansthan and Research Centre, Patna, Bihar 801505, India
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Huang YH, Loftfield E, Argirion I, Adami HO, Albanes D, Chan AT, Fedirko V, Fraser GE, Freedman ND, Giles GG, Hartge P, Katzke V, Knutsen SF, Lacey J, Liao LM, Luo J, Milne RL, O’Brien KM, Peters U, Poynter JN, Purdue MP, Robien K, Sandin S, Sandler DP, Setiawan VW, Kang JH, Simon TG, Sinha R, VoPham T, Weinstein SJ, White E, Zhang X, Zhu B, McGlynn KA, Campbell PT, Lee MH, Koshiol J. Association of tea and coffee consumption and biliary tract cancer risk: The Biliary Tract Cancers Pooling Project. Hepatology 2024; 79:1324-1336. [PMID: 38758104 PMCID: PMC11101691 DOI: 10.1097/hep.0000000000000748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/21/2023] [Indexed: 05/18/2024]
Abstract
BACKGROUND AND AIMS Tea and coffee are widely consumed beverages worldwide. We evaluated their association with biliary tract cancer (BTC) incidence. APPROACH AND RESULTS We pooled data from 15 studies in the Biliary Tract Cancers Pooling Project to evaluate associations between tea and coffee consumption and biliary tract cancer development. We categorized participants as nondrinkers (0 cup/day), moderate drinkers (>0 and <3 cups/day), and heavy drinkers (≥3 cups/day). We estimated multivariable HRs and 95% CIs using Cox models. During 29,911,744 person-years of follow-up, 851 gallbladder, 588 intrahepatic bile duct, 753 extrahepatic bile duct, and 458 ampulla of Vater cancer cases were diagnosed. Individuals who drank tea showed a statistically significantly lower incidence rate of gallbladder cancer (GBC) relative to tea nondrinkers (HR=0.77; 95% CI, 0.64-0.91), and intrahepatic bile duct cancer (IHBDC) had an inverse association (HR=0.81; 95% CI, 0.66-1.00). However, no associations were observed for extrahepatic bile duct cancer (EHBDC) or ampulla of Vater cancer (AVC). In contrast, coffee consumption was positively associated with GBC, with a higher incidence rate for individuals consuming more coffee (HR<3 cups/day =1.29; 95% CI, 1.01-1.66; HR≥3 cups/day =1.49; 95% CI, 1.11-1.99, Ptrend=0.01) relative to coffee nondrinkers. However, there was no association between coffee consumption and GBC when restricted to coffee drinkers. There was little evidence of associations between coffee consumption and other biliary tract cancers. CONCLUSIONS Tea consumption was associated with a lower incidence of GBC and possibly IHBDC. Further research is warranted to replicate the observed positive association between coffee and GBC.
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Affiliation(s)
- Yu-Han Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Erikka Loftfield
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Ilona Argirion
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Andrew T. Chan
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Veronika Fedirko
- Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gary E. Fraser
- School of Public Health, Loma Linda University, Loma Linda, CA, USA
| | - Neal D. Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Graham G. Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Patricia Hartge
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Center, DKFZ, 69120 Heidelberg, Germany
| | | | - James Lacey
- Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - Linda M. Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University Bloomington, Bloomington, Indiana
| | - Roger L. Milne
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Katie M. O’Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Ulrike Peters
- Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Jenny N. Poynter
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Mark P. Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Kim Robien
- Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - Veronica W Setiawan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jae H Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Tracey G. Simon
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Trang VoPham
- Epidemiology Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Stephanie J. Weinstein
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Emily White
- Epidemiology Program, Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Bin Zhu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Katherine A. McGlynn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Peter T. Campbell
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | - Mei-Hsuan Lee
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jill Koshiol
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
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Zanuso V, Nash T, Casolino R, Armstrong G, Pallise O, Milne J, Braconi C. Insights for clinical management from the real-life data of the centralized West of Scotland biliary cancer clinic. BMC Cancer 2024; 24:597. [PMID: 38755562 PMCID: PMC11097428 DOI: 10.1186/s12885-024-12279-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/17/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND With the increasing of novel therapeutics for the treatment of Biliary Tract Cancers (BTC), and the need to assess their socio-economic impacts for national licence approvals, it is as important as ever to have real-life data in national populations. METHODS AND RESULTS We performed an audit of the first 2 year-activity (Sep 2019-Sep 2021) of the centralized West-of-Scotland-BTC clinic. 122 patients accessed the service, including 68% with cholangiocarcinoma (CCA), 27% with gallbladder cancer (GBC), and 5% with ampulla of Vater carcinoma with biliary phenotype (AVC). Median age at diagnosis was 66 (28-84), with 30% of newly diagnosed patients being younger than 60 years-old. Thirty-five cases (29%) underwent surgery, followed by adjuvant-chemotherapy in 66%. 60% had recurrent disease (80% with distant relapse). Sixty-four patients (58%) started first-line Systemic-AntiCancer-Treatment (SACT). Of these, 37% received second line SACT, the majority of which had iCCA and GBC. Thirty-% of those who progressed received third line SACT. CONCLUSIONS About 30% of BTC were eligible for curative surgery. Fifty-eight and twenty% of the overall cohort of advanced BTC patients received first and second line SACT. Our data suggest that reflex genomic profiling may not be cost-effective until molecularly driven strategies are limited to second line setting.
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Affiliation(s)
- Valentina Zanuso
- School of Cancer Sciences, University of Glasgow, G61 1QH, Glasgow, UK
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Milan, Italy
| | - Tamsin Nash
- Beatson West of Scotland Cancer Centre, G12 0YN, Glasgow, UK
- NHS Greater Glasgow and Clyde, Glasgow, UK
| | | | | | - Ona Pallise
- Beatson West of Scotland Cancer Centre, G12 0YN, Glasgow, UK
- NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Jen Milne
- Beatson West of Scotland Cancer Centre, G12 0YN, Glasgow, UK
- NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Chiara Braconi
- School of Cancer Sciences, University of Glasgow, G61 1QH, Glasgow, UK.
- Beatson West of Scotland Cancer Centre, G12 0YN, Glasgow, UK.
- CRUK-Scotland Cancer Centre, Glasgow-Edinburgh, UK.
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Xiang Y, Qiu C, Hu H, Cai J, Da X, Kong X, Wang Y, He C, Zhang C, Yang Y. Age and incidence of occult pancreaticobiliary reflux in patients with benign gallbladder diseases. Scand J Gastroenterol 2024; 59:584-591. [PMID: 38318873 DOI: 10.1080/00365521.2024.2311358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/23/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Occult pancreaticobiliary reflux (OPBR) has a significant correlation with diseases of the gallbladder and biliary system. This study examined the incidence of OPBR by age in patients with benign gallbladder diseases. METHODS We assessed 475 patients with benign gallbladder diseases who underwent surgery at Shanghai East Hospital from December 2020 to December 2021. Bile samples collected during surgery were tested for amylase. Patients with bile amylase >110 U/L (n = 64) were classified as the OPBR group; the rest (n = 411) as controls. RESULTS Of the participants, 375 had gallbladder stone (GS), 170 had gallbladder polyp (GP), and 49 had gallbladder adenomyomatosis (GA). The OPBR group was generally older, with OPBR incidence increasing with age, peaking post-45. Rates by age were: 4.9% (<35), 5.2% (35-44), 20.7% (45-54), 22.5% (55-64) and 17.6% (≥65), mainly in GS patients. ROC analysis for predicting OPBR by age yielded an area under the curve of 0.656, optimal cut-off at 45 years. Logistic regression indicated age > 45, GP, male gender, and BMI ≥ 24 kg*m-2 as independent OPBR predictors in GS patients. Based on these variables, a predictive nomogram was constructed, and its effectiveness was validated using the ROC curve, calibration curve and decision curve analysis (DCA). Further stratification revealed that among GS patients ≤ 45, concurrent GA was an OPBR risk; for > 45, it was GP and male gender. CONCLUSIONS The incidence of OPBR in GS patients is notably influenced by age, with those over 45, especially males without GP, being at heightened risk.
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Affiliation(s)
- Yukai Xiang
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, PR China
| | - Chen Qiu
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, PR China
| | - Hai Hu
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, PR China
| | - Jingli Cai
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, PR China
| | - Xuanbo Da
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, PR China
| | - Xiangyu Kong
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, PR China
| | - Yubin Wang
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, PR China
| | - Chuanqi He
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, PR China
| | - Cheng Zhang
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, PR China
| | - Yulong Yang
- Center of Gallbladder Disease, Shanghai East Hospital, Institute of Gallstone Disease, School of Medicine, Tongji University, Shanghai, PR China
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Nakata K, Charvat H. Projection of the number of new cases of gallbladder cancer in the world. Jpn J Clin Oncol 2024; 54:504-505. [PMID: 38525939 DOI: 10.1093/jjco/hyae036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 03/06/2024] [Indexed: 03/26/2024] Open
Affiliation(s)
- Kayo Nakata
- Cancer Control Center, Osaka International Cancer Institute, Osaka-city, Osaka, Japan
- Division of International Health Policy Research, Institute for Cancer Control, National Cancer Center, Chuo-ku, Tokyo, Japan
| | - Hadrien Charvat
- Division of International Health Policy Research, Institute for Cancer Control, National Cancer Center, Chuo-ku, Tokyo, Japan
- Faculty of International Liberal Arts, Juntendo University, Bunkyo-ku, Tokyo, Japan
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Koshiol J, Zhu B, Wang R, Hildesheim A, Gao YT, Egner PA, Yuan JM, Groopman JD. Association of aflatoxin with gallbladder cancer in a case-control study nested within a Chinese cohort. Int J Cancer 2024; 154:801-806. [PMID: 37840351 PMCID: PMC10841509 DOI: 10.1002/ijc.34755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/16/2023] [Accepted: 08/31/2023] [Indexed: 10/17/2023]
Abstract
We evaluated whether aflatoxin B1 (AFB1 ) exposure was associated with later risk of developing gallbladder cancer (GBC). We measured AFB1 -lysine albumin adducts in baseline samples from the Shanghai Cohort Study of 18 244 men aged 45 to 64 years (recruited 1986-1989). We included 84 GBC cases with sufficient serum and 168 controls matched on age at sample collection, date of blood draw and residence. We calculated adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for detectable vs non-detectable AFB1 -lysine albumin adducts and gallbladder cancer. AFB1 -lysine albumin adducts were detected in 50.0% of GBC cases, and risk of GBC was twice as high in those with detectable vs undetectable levels (OR = 2.0, 95% CI = 1.0-3.9). ORs ranged from 1.8 (95% CI = 0.75-4.3) for 0.5 to <1.75 pg/mg vs undetectable adduct levels to 2.2 (95% CI = 0.91-5.6) for >3.36 pg/mg vs undetectable, suggesting a dose-response (Ptrend = .05). When restricted to cases diagnosed before the median time to diagnosis after blood draw (18.4 years), results were similar (OR = 2.2, 95% CI = 0.80-5.8) to those for the entire follow-up duration. The OR was 9.4 (95% CI = 1.7-51.1) for individuals with detectable AFB1 -lysine albumin adducts and self-reported gallstones compared to individuals with neither. Participants with detectable AFB1 -lysine albumin adducts at baseline had increased risk of developing GBC, replicating the previously observed association between AFB1 exposure and providing the first evidence of temporality.
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Affiliation(s)
- Jill Koshiol
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Bin Zhu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Renwei Wang
- UPMC Hillman Cancer Center & Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Allan Hildesheim
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
| | - Patricia A. Egner
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jian-Min Yuan
- UPMC Hillman Cancer Center & Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - John D. Groopman
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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van Dooren M, de Savornin Lohman EAJ, van der Post RS, Erdmann JI, Hoogwater FJH, Groot Koerkamp B, van den Boezem PB, de Reuver PR. Referral rate of patients with incidental gallbladder cancer and survival: outcomes of a multicentre retrospective study. BJS Open 2024; 8:zrae013. [PMID: 38513278 PMCID: PMC10957162 DOI: 10.1093/bjsopen/zrae013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 11/01/2023] [Accepted: 12/05/2023] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Treatment outcomes of incidental gallbladder cancer generally stem from tertiary referral centres, while many patients are initially diagnosed and managed in secondary care centres. Referral patterns of patients with incidental gallbladder cancer are poorly reported. This study aimed to evaluate incidental gallbladder cancer treatment in secondary centres, rates of referral to tertiary centres and its impact on survival. METHODS Medical records of patients with incidental gallbladder cancer diagnosed between 2000 and 2019 in 27 Dutch secondary centres were retrospectively reviewed. Patient characteristics, surgical treatment, tumour characteristics, referral pattern and survival were assessed. Predictors for overall survival were determined using multivariable Cox regression. RESULTS In total, 382 patients with incidental gallbladder cancer were included. Of 243 patients eligible for re-resection (pT1b-pT3, M0), 131 (53.9%) were referred to a tertiary centre. The reason not to refer, despite indication for re-resection, was not documented for 52 of 112 non-referred patients (46.4%). In total, 98 patients underwent additional surgery with curative intent (40.3%), 12 of these in the secondary centre. Median overall survival was 33 months (95% c.i. 24 to 42 months) in referred patients versus 17 months (95% c.i. 3 to 31 months) in the non-referred group (P = 0.019). Referral to a tertiary centre was independently associated with improved survival after correction for age, ASA classification, tumour stage and resection margin (HR 0.60, 95% c.i. 0.38 to 0.97; P = 0.037). CONCLUSION Poor incidental gallbladder cancer referral rates were associated with worse survival. Age, performance status, resection margin or tumour stage should not preclude referral of a patient with incidental gallbladder cancer to a tertiary centre.
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Affiliation(s)
- Mike van Dooren
- Department of Surgery, Radboudumc, Nijmegen, The Netherlands
| | | | | | - Joris I Erdmann
- Department of Surgery, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Frederik J H Hoogwater
- Department of Hepatobiliary and Transplant Surgery, University Medical Center Groningen, Groningen, The Netherlands
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Shridhar K, Krishnatreya M, Kumar R, Kondal D, Bhattacharyya M, Kalita B, Snehil P, Singh AK, Kataki AC, Ghosh A, D Prabhakaran, Prabhakaran P, Dhillon PK. Household cooking fuel and gallbladder cancer risk: a multi-centre case-control study in India. Cancer Causes Control 2024; 35:281-292. [PMID: 37733135 DOI: 10.1007/s10552-023-01787-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 08/27/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE Gallbladder cancers (GBC), unique to certain geographical regions, are lethal digestive tract cancers, disproportionately affecting women, with limited information on risk factors. METHODS We evaluated the association between household cooking fuel and GBC risk in a hospital-based case-control study conducted in the North-East and East Indian states of Assam and Bihar. We explored the potential mediation by diet, fire-vents, 'daily exposure duration' and parity (among women). We recruited biopsy-confirmed GBC (n = 214) men and women aged 30-69 years between 2019 and 2021, and controls frequency-matched by age, sex and region (n = 166). Information about cooking fuel, lifestyle, personal and family history, female reproductive factors, socio-demographics, and anthropometrics was collected. We tested associations using multivariable logistic regression analyses. RESULTS All participants (73.4% women) were categorised based on predominant cooking fuel use. Group-1: LPG (Liquefied Petroleum Gas) users in the previous 20 years and above without concurrent biomass use (26.15%); Group-2: LPG users in the previous 20 years and above with concurrent secondary biomass use (15.9%); Group-3: Biomass users for ≥ 20 years (57.95%). Compared to group-1, accounting for confounders, GBC risk was higher in group-2 [OR: 2.02; 95% CI: 1.00-4.07] and group-3 [OR: 2.01; 95% CI: 1.08-3.73] (p-trend:0.020). These associations strengthened among women that attenuated with high daily consumption of fruits-vegetables but not with fire-vents, 'daily exposure duration' or parity. CONCLUSION Biomass burning was associated with a high-risk for GBC and should be considered as a modifiable risk factor for GBC. Clean cooking fuel can potentially mitigate, and a healthy diet can partially reduce the risk among women.
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Affiliation(s)
- Krithiga Shridhar
- Centre for Chronic Disease Control, C1/52, 2nd Floor, Safdarjung Development Area, New Delhi, 110016, India.
- Public Health Foundation of India, Plot No 47, Sector 44, Institutional Area, Gurugram, 122002, Haryana, India.
| | - Manigreeva Krishnatreya
- Dr. Bhubaneshwar Borooah Cancer Institute, AK Azad Road, Gopinath Nagar Road, Bishnu Rabha Nagar, Guwahati, 781016, Assam, India
| | - Ranjit Kumar
- Mahavir Cancer Sansthan and Research Centre, Phulwarisharif, Patna, 801505, Bihar, India
- Central University of Himachal Pradesh, Dharamshala, Kangra, 176215, Himachal Pradesh, India
| | - Dimple Kondal
- Centre for Chronic Disease Control, C1/52, 2nd Floor, Safdarjung Development Area, New Delhi, 110016, India
| | - Mouchumee Bhattacharyya
- Dr. Bhubaneshwar Borooah Cancer Institute, AK Azad Road, Gopinath Nagar Road, Bishnu Rabha Nagar, Guwahati, 781016, Assam, India
| | - Banti Kalita
- Public Health Foundation of India, Plot No 47, Sector 44, Institutional Area, Gurugram, 122002, Haryana, India
| | - Prakriti Snehil
- Public Health Foundation of India, Plot No 47, Sector 44, Institutional Area, Gurugram, 122002, Haryana, India
| | - Amulya K Singh
- Akshat Seva Sadan, Yarpur, Gardanibagh, Patna, 800001, Bihar, India
| | - Amal Chandra Kataki
- Dr. Bhubaneshwar Borooah Cancer Institute, AK Azad Road, Gopinath Nagar Road, Bishnu Rabha Nagar, Guwahati, 781016, Assam, India
| | - Ashok Ghosh
- Mahavir Cancer Sansthan and Research Centre, Phulwarisharif, Patna, 801505, Bihar, India
| | - D Prabhakaran
- Centre for Chronic Disease Control, C1/52, 2nd Floor, Safdarjung Development Area, New Delhi, 110016, India
- Public Health Foundation of India, Plot No 47, Sector 44, Institutional Area, Gurugram, 122002, Haryana, India
- London School of Hygiene and Tropical Medicine, Bloomsbury, London, UK
| | - Poornima Prabhakaran
- Centre for Chronic Disease Control, C1/52, 2nd Floor, Safdarjung Development Area, New Delhi, 110016, India
- Public Health Foundation of India, Plot No 47, Sector 44, Institutional Area, Gurugram, 122002, Haryana, India
| | - Preet K Dhillon
- Centre for Chronic Disease Control, C1/52, 2nd Floor, Safdarjung Development Area, New Delhi, 110016, India
- Genentech Roche, San Francisco Bay Area, CA, 94080, USA
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10
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Hajibandeh S, Ashar S, Parry C, Ellis-Owen R, Kumar N. The risk and predictors of gallbladder cancer in patients with gallbladder polyps: A retrospective cohort study with an insight into confounding by indication. J Gastroenterol Hepatol 2023; 38:2247-2253. [PMID: 37926936 DOI: 10.1111/jgh.16399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/09/2023] [Accepted: 10/18/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND AND AIM We aimed to determine the risk and predictors of gallbladder cancer in all individuals with gallbladder polyps (GP) including those who did not have cholecystectomy. METHODS The STROCSS guideline was followed to conduct a retrospective cohort study. All individuals with GP between 2010 and 2019 were followed up to determine the risk and predictors of gallbladder cancer. The primary outcomes were gallbladder cancer and gallbladder dysplasia, and the secondary outcomes included polyp growth rate and polyp disappearance rate. Binary logistic regression analysis and receiver operating characteristic curve analysis were conducted to evaluate the outcomes. RESULTS Analysis of 438 patients showed risk of gallbladder cancer was 0.7% in all polyps (0% in polyps < 10 mm; 5.9% in polyps ≥ 10 mm). The risk of gallbladder dysplasia or cancer was 1.1% in all polyps (0% in polyps < 10 mm; 10% in polyps ≥ 10 mm). The polyp size (P = 0.0001) was predictor of cancer; however, patient's age (P = 0.1085), number of polyps (P = 0.9983), symptomatic polyps (P = 0.3267), and change in size (P = 0.9012) were not. Size of 21 mm was cut-off for risk of cancer (area under the curve [AUC]: 0.995, P < 0.001) and 11.8 mm for risk of dysplasia or cancer (AUC: 0.986, P < 0.001). The mean polyp growth rate was 0.3 mm/year and polyp disappearance rate was 16%. CONCLUSIONS The GP size remains the only predictor of malignant changes regardless of patient's age, patient's symptoms and number of polyps. The polyp growth rate is unremarkable, and a significant proportion disappears during follow-up. We changed our follow-up protocol with reduced number of scans and early discharge policy.
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Affiliation(s)
- Shahab Hajibandeh
- Cardiff Liver Unit, University Hospital of Wales, Cardiff and Vale NHS Trust, Cardiff, UK
| | - Sana Ashar
- Cardiff Liver Unit, University Hospital of Wales, Cardiff and Vale NHS Trust, Cardiff, UK
| | - Craig Parry
- Department of Radiology, University Hospital of Wales, Cardiff and Vale NHS Trust, Cardiff, UK
| | - Rwth Ellis-Owen
- Department of Radiology, University Hospital of Wales, Cardiff and Vale NHS Trust, Cardiff, UK
| | - Nagappan Kumar
- Cardiff Liver Unit, University Hospital of Wales, Cardiff and Vale NHS Trust, Cardiff, UK
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Wen W, Mumma M, Zheng W. Temporal Trends of Stages and Survival of Biliary Tract Cancers in the United States and Associations with Demographic Factors. Cancer Epidemiol Biomarkers Prev 2023; 32:1660-1667. [PMID: 37606709 PMCID: PMC10840886 DOI: 10.1158/1055-9965.epi-23-0562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/26/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND The incidence of cholangiocarcinoma and gallbladder cancer has been increasing and decreasing respectively in the United States, whereas their mortality has been declining since 1980, which suggests improved overall survival of biliary tract cancers (BTC). We aimed to investigate temporal trends of BTC stages and survival and their associations with demographic factors. METHODS A total of 55,163 patients with BTC collected from 2000 to 2018 from the NCI Surveillance, Epidemiology, and End Results 18 registry were included in this study. We assessed the temporal trend of BTC stages with diagnosis years using the annual percentage of change (APC) in the proportion of the stages. We estimated the association of BTC survival and stages with diagnosis years and demographic factors using the Cox regression models. RESULTS While localized BTC proportion remained little changed from 2006 to 2018, the proportion of regional and distant BTCs significantly decreased (APC = -2.3%) and increased (APC = 2.7%), respectively, through the years. The overall and cancer-specific survival increased from 41.0% and 47.3% in 2000 to 2004 to 51.2% and 53.8% in 2015 to 2018, respectively. Patients with BTC who were older, Black, unmarried, or had lower socioeconomic status (SES) had significantly poorer overall survival. CONCLUSIONS We found that distant and regional BTC significantly increased and decreased, respectively, and the BTC survival significantly improved over time. Age, sex, race, SES, and marital status were significantly associated with overall survival and less evidently with cancer-specific survival of patients with BTC. IMPACT Our findings suggest that demographic factors were associated with BTC stages and BTC survival.
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Affiliation(s)
- Wanqing Wen
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Michael Mumma
- International Epidemiology Field Station, Vanderbilt University Medical Center, Nashville, TN
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
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Vuthaluru S, Sharma P, Chowdhury S, Are C. Global epidemiological trends and variations in the burden of gallbladder cancer. J Surg Oncol 2023; 128:980-988. [PMID: 37818916 DOI: 10.1002/jso.27450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 09/08/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Gallbladder cancer (GBC) is a rare but lethal malignancy with a dismal prognosis. The aim of this study is to analyze the burdens and trends of GBC across the world based on geography, socioeconomic development (based on human development index [HDI]), and gender. METHODS GLOBOCAN 2020 database was used to extract data (2020-2040) relating to the incidence and mortality of GBC across the world. RESULTS Asia had the highest burden of GBC with India and China contributing to majority of the absolute burden. The burden of GBC by age standardized rate was highest in Latin America (Bolivia and Chile) and Southeast Asia (Bangladesh and Nepal). Medium HDI countries had a higher mortality rate compared to very high HDI countries. Females had a higher predilection for GBC across different regions and socioeconomic groups. GBC burden is expected to significantly increase across the world by 2040 with variable trends across different regions, age groups, and genders. CONCLUSION The global burden of GBC will significantly increase over the next two decades with marked regional and demographic variations. The results of this study will empower national and global health leaders to develop policies to address the increasing burden of this lethal malignancy.
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Affiliation(s)
- Srineil Vuthaluru
- Department of Surgery, Division of Surgical Oncology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Prateek Sharma
- Department of Surgery, Division of Surgical Oncology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Sanjib Chowdhury
- Department of Surgery, Division of Surgical Oncology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Chandrakanth Are
- Department of Surgery, Division of Surgical Oncology, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Malik H, Izwan S, Ng J, Teng R, Chan E, Damodaran Prabha R, Puhalla H. Incidence and management of gallbladder cancer in cholecystectomy specimens: a 5-year tertiary centre experience. ANZ J Surg 2023; 93:2481-2486. [PMID: 37338023 DOI: 10.1111/ans.18577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 05/19/2023] [Accepted: 06/12/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Gallbladder cancer (GBC) is an uncommon, but highly aggressive cancer. Half of these cases are diagnosed pre-operatively, and the remaining cases are discovered incidentally on post-cholecystectomy specimens. There is a significant geographical variability in GBC incidence, with increasing age, female sex, and prolonged duration of cholelithiasis being risk factors for GBC. The primary aim was to define the overall local incidence of GBC incidental GBC and management of these cases. The secondary aim was to determine any pertinent risk factors in our case population. METHODS A retrospective observational study was performed on all the cholecystectomy specimens at the Gold Coast Hospital and Health Service from 1 January 2016 to 2 December 2021. Data was collected via the electronic medical record. The incidence and management of gallbladder cancers was calculated, and association with body mass index (BMI), smoking status, diabetes, inflammatory bowel disease (IBD) was identified. RESULTS 3904 cholecystectomy specimens were reviewed. GBC was identified in 0.46% of cholecystectomies. 50% of these cases were found incidentally. Abdominal pain was the most common presenting complaint (94.4%). GBC was associated with increased age and BMI and female sex. There was no association between smoking status, diabetes or IBD with an increased incidence of cancer. Tumour staging guided surgical and/or adjuvant chemotherapy. CONCLUSION GBC is rare. Patients with symptoms are associated with a poor prognosis. Incidental cancers are common, and negative margin resection based on the T stage of the cancer is the most reliable curative option.
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Affiliation(s)
- Hassan Malik
- Department of General Surgery, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Sara Izwan
- Department of General Surgery, Gold Coast University Hospital, Gold Coast, Queensland, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Justin Ng
- Department of General Surgery, Gold Coast University Hospital, Gold Coast, Queensland, Australia
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Roy Teng
- Department of General Surgery, Gold Coast University Hospital, Gold Coast, Queensland, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Erick Chan
- Department of General Surgery, Gold Coast University Hospital, Gold Coast, Queensland, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Ramesh Damodaran Prabha
- Department of General Surgery, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Harald Puhalla
- Department of General Surgery, Gold Coast University Hospital, Gold Coast, Queensland, Australia
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
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Seguin CL, Davidi B, Peters MLB, Eckel A, Harisinghani MG, Goiffon RJ, Knudsen AB, Pandharipande PV. Ultrasound Surveillance of Small, Incidentally Detected Gallbladder Polyps: Projected Benefits by Sex, Age, and Comorbidity Level. J Am Coll Radiol 2023; 20:1031-1041. [PMID: 37406750 PMCID: PMC10777737 DOI: 10.1016/j.jacr.2023.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 04/03/2023] [Accepted: 05/06/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVE Incidentally detected gallbladder polyps are commonly encountered when performing upper abdominal ultrasound. Our purpose was to estimate the life expectancy (LE) benefit of ultrasound-based gallbladder surveillance in patients with small (6-7 to <10 mm), incidentally detected gallbladder polyps, accounting for patient sex, age, and comorbidity level. METHODS We developed a decision-analytic Markov model to evaluate hypothetical cohorts of women and men with small gallbladder polyps, with varying age (66-80 years) and comorbidity level (none, mild, moderate, severe). Drawing from current evidence, in the base case, we assumed no increased risk of gallbladder cancer in patients with small gallbladder polyps. To estimate maximal possible LE gains from surveillance, we assumed perfect cancer control consequent to 5 years of surveillance. We varied key assumptions including cancer risk and test performance characteristics in sensitivity analysis. RESULTS Projected LE gains from surveillance were <3 days across most cohorts and scenarios evaluated. For 66- and 80-year-olds with no comorbidities, LE gains were 1.46 and 1.45 days, respectively, for women, and 0.67 and 0.75 days for men. With 10 years of surveillance, LE gains increased to 2.94 days for 66-year-old women with no comorbidities (men: 1.35 days). If we assumed a 10% increase in gallbladder cancer risk among individuals with polyps, LE gains increased slightly to 1.60 days for 66-year-old women with no comorbidities (men: 0.74 days). Results were sensitive to test performance and surgical mortality. DISCUSSION Even under unrealistic, optimistic assumptions of cancer control, ultrasound surveillance of incidentally detected small gallbladder polyps provided limited benefit.
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Affiliation(s)
- Claudia L Seguin
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts
| | - Barak Davidi
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts
| | - Mary Linton B Peters
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts; Division of Medical Oncology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Andrew Eckel
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts
| | - Mukesh G Harisinghani
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Director of Abdominal MRI, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Reece J Goiffon
- Harvard Medical School, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Amy B Knudsen
- Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Pari V Pandharipande
- Chair of Radiology, Ohio State University College of Medicine, Columbus, Ohio; and Chief of Radiology Services for the Ohio State University Wexner Medical Center Health System, Columbus, Ohio.
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Feroz Z, Tiwari S, Vijayaraghavalu S, Kumar M. GSTs genetic polymorphism, gene-environment interaction and association with gallbladder cancer risk in North Indian population: A case-controlled study. J Cancer Res Ther 2023; 19:1908-1914. [PMID: 38376296 DOI: 10.4103/jcrt.jcrt_1117_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 04/11/2022] [Indexed: 02/21/2024]
Abstract
AIM In the present case-controlled study, we explored the role of genetic polymorphism in three xenobiotic metabolizing genes, GSTM1, GSTT1 and GSTP1, and their association to gallbladder cancer (GBC) risk in a North Indian population. Its etiology is influenced by genetic, food habits, lifestyle, and environmental factors. GBC incidence is significantly higher in the Gangetic belt, India. Therefore, we explored the prognostic factors in the susceptibility of GBC through gene-gene and gene-environment interaction in this region. MATERIAL AND METHODS Genetic polymorphism was analyzed in 108 GBC patients from Kamala Nehru Memorial Cancer Hospital, Prayagraj and 142 matched controls. GSTM1 and GSTT1 genotypes were analyzed by multiplex PCR method, while restriction fragment length polymorphism (RFLP) was performed to analyze GSTP1 genotypes. Logistic regression analysis calculating the odds ratio (OR) and 95% confidence interval (CI) was performed to analyze the GBC risk. RESULTS GSTT1 (null) genotype was at a significantly higher risk and susceptible to GBC (OR = 2.044, CI = 1.225-3.411, P = 0.006), while GSTM1 and GSTP1 genotypes did not show any association to GBC risk. After sex stratification, females diagnosed with GBC had higher GSTT1 (null) genotype (OR = 2.754, CI = 1.428-5.310, P = 0.003) compared to males. GBC patients dwelling in rural areas show higher GSTT1 (null) genotype with two-fold GBC risk (OR = 2.031, CI = 1.200-3.439, P = 0.008). Further, GBC patients with histopathology of adenocarcinoma also showed higher GSTT1 (null) genotype (OR = 2.113, CI = 1.248-3.578, P = 0.005). Gene-gene interaction between GSTT1 (non-null)/GSTP1 (Ile/Val + Val/Val), enhance the GBC risk (OR = 1.840, CI = 1.135-2.982, P = 0.013). CONCLUSIONS The present study suggests that GSTT1 (null) genotype has higher susceptibility and risk towards GBC in North Indian population. Female patients, patients with histopathology of adenocarcinoma and rural dwelling GBC patients have higher GSTT1 (null) genotypes and may be at risk of developing GBC. The genotype combination GSTT1 (non-null)/GSTP1 (Ile/Val + Val/Val) has increased GBC susceptibility and may be considered as 'at risk' genotypes for GBC in North Indians.
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Affiliation(s)
- Zainab Feroz
- Department of Biochemistry, University of Allahabad, Prayagaj, UP, India
| | - Sonia Tiwari
- Department of Radiation Oncology, Kamala Nehru Memorial Hospital, Prayagraj, UP, India
| | | | - Munish Kumar
- Department of Biochemistry, University of Allahabad, Prayagaj, UP, India
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16
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Sheng BW, Zhang JQ, Chen M, Ma M. The inverse association between fasting blood glucose and the occurrence of gallbladder cancer in type 2 diabetes mellitus patients: a case-control study. J Cancer Res Clin Oncol 2023; 149:10387-10398. [PMID: 37273108 DOI: 10.1007/s00432-023-04944-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/26/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE This study aimed to explore the correlation between diabetes mellitus (DM) and gallbladder cancer (GBC) in an epidemiological setting. METHODS The study summarized the clinical and laboratory data of 2210 GBC Chinese patients in the authors' hospital. A total of 17 influencing factors for GBC, including gender, body mass index (BMI), fasting blood glucose (FBG), fasting insulin (FINS), the homeostasis model assessment of insulin resistance (HOMA-IR), retinol-binding protein 4 (RBP4), and lipid indexes were analyzed using unconditional logistic regression analysis. RESULTS Based on the results of univariate logistic regression, the risk of GBC was significantly and positively correlated with serum triglyceride, low-density lipoprotein, FINS, HOMA-IR, being female, BMI, DM, non-alcoholic fatty liver disease, and gallbladder stone disease (GSD), and significantly negatively correlated with high-density lipoprotein and FBG concentrations in serum, as well as hypertension. According to multivariate analysis, FINS was significantly positively associated with GBC risk, while DM showed an insignificant negative association; FBG was also not important. The most significant independent factor of GBC risk in patients with DM was HOMA-IR. Fasting blood glucose levels showed a significant negative relationship with GBC in patients with DM. In addition, this study indicated a significantly negative association between serum RBP levels and GBC. CONCLUSIONS The findings of the current study revealed that the efficient treatment of insulin resistance is an important approach for decreasing GBC risk, as opposed to lowering blood sugar only, particularly in patients with DM. Interestingly, FBG may have had an inverse association with the development of GBC in patients with type 2 DM. Of note, the study found that a dramatic initial drop in RBP may help predict the occurrence of GBC.
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Affiliation(s)
- Bin-Wu Sheng
- Department of Geriatric Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 West Yanta Road, Xi'an, 710061, China.
| | - Jian-Qin Zhang
- Shaanxi Nutrition Society, Medical School, of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Min Chen
- Biobank, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Mao Ma
- Department of Geriatric Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 West Yanta Road, Xi'an, 710061, China.
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Xia Y, Lu S, Huo C, Fan L, Lin M, Huang J. Non cancer causes of death after gallbladder cancer diagnosis: a population-based analysis. Sci Rep 2023; 13:13746. [PMID: 37612302 PMCID: PMC10447554 DOI: 10.1038/s41598-023-40134-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 08/05/2023] [Indexed: 08/25/2023] Open
Abstract
Mortality from non cancer causes in patients with gallbladder cancer (GBC) still unclear. This study evaluated the causes and risk factors of non cancer death during different follow-up periods after GBC diagnosis. Non cancer causes of death for GBC patients diagnosed between 2000 and 2017 in Surveillance, Epidemiology and End Results database were analyzed and standardized mortality rates (SMR) for each non cancer death were calculated. Predictors for non cancer death were identified through multivariate competing risk analysis. A total 11,927 GBC patients were identified for further analysis, 9393 died during follow up. The largest proportion of non cancer deaths occurred > 3 years after diagnosis (39.4%). Most common non cancer cause were cardiovascular disease (43.3%), followed by other cause of death (34.4%) and infectious diseases (8.6%). Compared with US general population, GBC patients has higher risk of death from disease of heart (SMR, 1.58; 95%CI, 1.41-1.75), septicemia (SMR,3.21; 95%CI, 2.27-4.40), diabetes mellitus (SMR,1.97; 95%CI, 1.43-2.63), alone with other causes. Non cancer causes accounted for a significant proportion of deaths during the follow-up period after GBC diagnosis. The risk of non cancer death is higher in GBC patients than in the general population. Our study provides comprehensive assessment of death from non cancer cause in GBC patients, which has important implications for health management in GBC patients.
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Affiliation(s)
- Yang Xia
- Department of Gastroenterology, The Affliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Shuangshuang Lu
- Department of Gastroenterology, The Affliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Chunyan Huo
- Department of Gastroenterology, The Affliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Li Fan
- Department of Gastroenterology, The Affliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Min Lin
- Department of Gastroenterology, The Affliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, China.
| | - Jin Huang
- Department of Gastroenterology, The Affliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, China.
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Dulskas A, Cerkauskaite D, Patasius A, Smailyte G. Incidence, Mortality, and Survival Trends in Cancer of the Gallbladder and Extrahepatic Bile Ducts in Lithuania. Medicina (B Aires) 2023; 59:medicina59040660. [PMID: 37109618 PMCID: PMC10142892 DOI: 10.3390/medicina59040660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/17/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
Background and Objectives: Gallbladder cancer is a rare type of cancer, with aggressive clinical behavior. Limited treatment options provide poor survival prognosis. We aimed to investigate the incidence, mortality trends, and survival of gallbladder and extrahepatic bile duct cancer in Lithuania between 1998 and 2017. Materials and Methods: The study was based on the Lithuanian Cancer Registry database. The study included all cases of cancer of the gallbladder and extrahepatic bile ducts reported to the Registry in the period 1998–2017. Age-specific and age-standardized incidence rates were calculated. In addition, 95% confidence intervals for APC (Annual Percent Change) were calculated. Changes were considered statistically significant if p was <0.05. Relative survival estimates were calculated using period analysis according to the Ederer II method. Results: Age-standardized rates for gallbladder cancer and extrahepatic bile duct cancer among females decreased from 3.91 to 1.93 cases per 100.000 individuals between 1998 and 2017, and from 2.32 to 1.59 cases per 100.000 individuals between 1998 and 2017 among males. The highest incidence rates were found in the 85+ group with 27.5/100,000 individuals in females and 26.8/100,000 individuals in males. The 1-year as well as 5-year relative survival rates of both genders were 34.29% (95% CI 32.12–36.48) and 16.29% (95% CI 14.40–18.27), respectively. Conclusions: Incidence and mortality from gallbladder and extrahepatic bile duct cancer decreased in both sexes in Lithuania. Incidence and mortality rates were higher in females than in males. Relative 1-year and 5-year survival rates showed a steady increase during the study period among males and females.
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Affiliation(s)
- Audrius Dulskas
- Department of Abdominal and General Surgery and Oncology, National Cancer Institute, 1 Santariskiu Str., LT-08406 Vilnius, Lithuania
- SMK, University of Applied Social Sciences, LT-08211 Vilnius, Lithuania
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Čiurlionio Str. 21/27, LT-03101 Vilnius, Lithuania
- Correspondence: ; Tel.: +370-67520094
| | - Dovile Cerkauskaite
- Faculty of Medicine, Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, LT-44307 Kaunas, Lithuania
| | - Ausvydas Patasius
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania
- Laboratory of Cancer Epidemiology, National Cancer Institute, 1 Santariskiu Str., LT-08406 Vilnius, Lithuania
| | - Giedre Smailyte
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania
- Laboratory of Cancer Epidemiology, National Cancer Institute, 1 Santariskiu Str., LT-08406 Vilnius, Lithuania
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De Palma G, Carrasco-Avino G, Gilberti E, Cadei M, Pedrazzi T, Gallegos Mendez IM, Roman A, Demartines N, Boffetta P, Labgaa I. Arsenic may be a carcinogenic determinant of a subset of gallbladder cancer: A pilot study. Environ Res 2023; 219:115030. [PMID: 36509118 DOI: 10.1016/j.envres.2022.115030] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/24/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
Gallbladder cancer (GBC) is one of the deadliest malignancy and treatment options are deplorably limited. Better strategies of prevention are urgently needed but knowledge on risk factors remains scarce. Recent data suggested that arsenic (As) may be involved in GBC carcinogenesis but the question remains debated. To date, there are no data on As measurement in GBC samples. This pilot study aimed to measure As concentrations in tissue samples from patients with GBC compared to non-cancerous gallbladder (NCGB). Included patients underwent cholecystectomy at Hospital Clinico Universidad de Chile, Santiago in Chile, a country with high As exposure, between 2001 and 2020. Tissue samples were preserved in formalin-fixed, paraffin-embedded blocks. Selected samples were retrieved, processed and submitted to inductively coupled plasma mass spectrometry (ICP-MS) to determine As concentrations. A total of 77 patients were included, including 35 GBC and 42 NCGB. The two groups were comparable, except for age (68 vs. 49 years, p < 0.001). Measured in 11 GBC and 38 NCGB, total As was detected in 5 GBC (14%) compared to 0 NCGB samples (p < 0.001). GBC group also showed higher median values of As compared to NCGB (p < 0.001). This pilot study provided a proof-of-concept to measure As concentrations in gallbladder samples and showed higher level of As in GBC samples compared to NCGB, paving the way for future studies aiming to investigate the impact of As on GBC, which may contribute to the prevention of this deadly disease.
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Affiliation(s)
- Giuseppe De Palma
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy; Unit of Occupational Health, Occupational Hygiene, Toxicology and Prevention, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Gonzalo Carrasco-Avino
- Department of Pathology, Hospital Clinico Universidad de Chile, Santiago, Chile; Department of Pathology, Clinica Las Condes, Santiago, Chile
| | - Enrica Gilberti
- Unit of Occupational Health, Occupational Hygiene, Toxicology and Prevention, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Moris Cadei
- Pathology Unit, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Tatiana Pedrazzi
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | | | - Alejandra Roman
- Department of Pathology, Hospital Clinico Universidad de Chile, Santiago, Chile
| | - Nicolas Demartines
- Department of Visceral Surgery, University Hospital of Lausanne (CHUV), University of Lausanne (UNIL), Switzerland
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, USA; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Ismail Labgaa
- Department of Visceral Surgery, University Hospital of Lausanne (CHUV), University of Lausanne (UNIL), Switzerland.
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20
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Park JH, Hong JY, Han K. Threshold dose-response association between smoking pack-years and the risk of gallbladder cancer: A nationwide cohort study. Eur J Cancer 2023; 180:99-107. [PMID: 36592508 DOI: 10.1016/j.ejca.2022.11.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 11/16/2022] [Accepted: 11/23/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS The association between smoking and gallbladder cancer (GBC) risk is unclear. We investigated the association between smoking (including pack-years) and GBC risk. We also examined the combined effects of smoking and diabetes or prediabetes on GBC risk. METHODS This Korean nationwide cohort study included 9,520,629 adults without cancer who underwent national health screening in 2009 and were followed-up until 2018. Multivariable Cox proportional hazards models were used to determine risk estimates after adjusting for potential confounders. RESULTS During 78.4 million person-years (mean 8.2 ± 0.9 years) of follow-up, we identified 6066 patients with newly diagnosed GBC. Current and former smokers were associated with increased GBC risk (hazard ratio [HR], 95% confidence interval [CI]: 1.117, 1.029-1.212 and 1.105, 1.016-1.202, respectively). Smoking of 20 to <30 and ≥30 pack-years was independently associated with increased GBC risk compared with never smoking (HR, 95% CI; 1.241, 1.100-1.400 and 1.231, 1.107-1.370, respectively). However, smoking of <10 and 10 to <20 pack-years was not. This threshold dose-response association between smoking pack-years and GBC risk was observed regardless of the glycaemic status (all P < 0.01). Furthermore, smoking of ≥20 pack-years and hyperglycaemia had a synergistic effect on the GBC risk (all P < 0.01). Smokers with ≥20 pack-years with diabetes had the highest risk of GBC compared to never smokers with normoglycaemia (HR, 1.658; 95% CI, 1.437-1.914). CONCLUSIONS Smoking was associated with increased GBC risk with a threshold dose-response effect for smoking pack-years. The risk of GBC increases synergistically when smoking and hyperglycaemia coexist. More individualised cancer prevention education is required to reduce GBC risk.
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Affiliation(s)
- Joo-Hyun Park
- Department of Family Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea; Department of Healthcare Administration and Policy, School of Public Health, University of Nevada Las Vegas, USA
| | - Jung Yong Hong
- Department of Healthcare Administration and Policy, School of Public Health, University of Nevada Las Vegas, USA; Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
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21
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Silva DAGDA, Veloso OLL, Valadares MSP, Costa RSDA, Silveira MG, Carvalho FCDE, Sousa MG. Incidental gallbladder cancer: what is the prevalence and how do we perform cholecystectomy for presumably benign biliary disease? Rev Col Bras Cir 2023; 49:e20223417. [PMID: 36629721 PMCID: PMC10578791 DOI: 10.1590/0100-6991e-20223417-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/05/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE to determine the prevalence of incidental gallbladder cancer (IGBC) in cholecystectomies performed in a tertiary public hospital and to describe technical and epidemiological aspects of performing cholecystectomies for presumably benign disease. METHOD descriptive, retrospective observational study, based on analysis of medical records of patients undergoing cholecystectomy with preoperative hypothesis of benign disease between January 2018 and January 2022. RESULTS prevalence of gallbladder adenocarcinoma in our sample was 0.16%, similar to data in the literature. Technical aspects during cholecystectomy were also described with a frequency similar to that found in the literature. CONCLUSION despite a rare disease, IGBC is relevant in the routine of the General Surgeon. Its diagnosis, staging and treatment directly affect the prognosis. Technical aspects during cholecystectomy are not always remembered by surgeons and can interfere with the prognosis and subsequent treatment of the patient.
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Affiliation(s)
- Diego Arley Gomes DA Silva
- - Universidade Federal da Paraíba, Departamento de Cirurgia - João Pessoa - PB - Brasil
- - Instituto do Coração do Hospital das Clínicas da FMUSP, Disciplina de Cirurgia Torácica - São Paulo - SP - Brasil
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22
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Makiuchi T, Sobue T. Descriptive epidemiology of biliary tract cancer incidence and geographic variation in Japan. Eur J Cancer Prev 2023; 32:2-9. [PMID: 35485392 DOI: 10.1097/cej.0000000000000758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The epidemiologic features of each biliary tract cancer (BTC) subtype have not been studied and disclosed in detail. The objective of this study was to provide an up-to-date description of the epidemiologic features of BTC by subtypes, especially in terms of the geographic variation of its incidence. METHODS We calculated the age-standardized incidence rate (ASR) of each BTC subtype at national and prefectural levels using the data from the national cancer registry in 2016 and 2017. The geographic distribution of each BTC subtype incidence was assessed by calculating the ASR ratio (ASRR) against median ASR at the prefectural level and reflecting them on the Japanese map. RESULTS A total of 58 438 people diagnosed with malignant BTC were registered in the national cancer registry in 2016 and 2017 [12 497 for intrahepatic bile duct cancer (IHBDC), 16 568 for gallbladder cancer (GBC), 24 602 for extrahepatic bile duct cancer (EHBDC), 4613 for ampulla of Vater cancer (AVC) and 158 for others]. ASR was higher in men than in women for IHBDC, EHBDC and AVC, and similar between men and women for GBC. The ASR of EHBDC was approximately 2 times higher than those of the other subtypes for men and similar to that of GBC for women. The geographic distribution of ASRR was different among BTC subtypes, with larger variability in EHBDC, which was remarkably higher in the north-eastern region in both men and women. CONCLUSION The pattern of the geographic distribution of incidence in each BTC subtype was different, which suggests different etiology among subtypes.
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Affiliation(s)
- Takeshi Makiuchi
- Division of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Suita Osaka, Japan
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23
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Prognostic factors in patients with gallbladder adenocarcinoma identified using competing-risks analysis: A study of cases in the SEER database: Erratum. Medicine (Baltimore) 2022; 101:e32166. [PMID: 36482547 DOI: 10.1097/MD.0000000000032166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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24
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Wan Y, Zhang J, Chen M, Ma M, Sheng B. Elevated serum triglyceride levels may be a key independent predicting factor for gallbladder cancer risk in gallbladder stone disease patients: a case-control study. BMC Endocr Disord 2022; 22:270. [PMID: 36348328 PMCID: PMC9641798 DOI: 10.1186/s12902-022-01189-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Gallbladder stone diseases (GSD) is a main risk factor of gallbladder cancer (GBC). This study aimed to reveal their bridge to metabolic syndrome. MATERIAL/METHOD The clinical and experimental data of 2210 GBC patients, from 3524 Chinese patients, in our hospital from Jan. 2009 to Dec. 2020 were summarized. The metabolic syndrome indexes, influencing factors for both GBC and GSD, were analyzed by unconditional logistic regression in this case-control study. RESULT There were significantly higher morbidity of GBC in the overall, GSD and non-GSD with hypertriglyceridemia patients versus non-hypertriglyceridemia ones (P < 0.001, all). In GSD patients, univariate regression showed a significantly positive correlation between serum triglyceride (TG), low density lipoprotein cholesterol (LDL-c), fasting insulin (FINS) levels, Homeostasis model assessment-insulin resistance (HOMA-IR), female being, body mass index, hypertriglyceridemia and hazard of GBC with GSD (P < 0.001, all), and a significantly negative correlation to systolic pressure (SBP), diastolic pressure (DBP), hypertension and high-density lipoprotein cholesterol (HDL-c), fasting blood glucose (FBG) (P < 0.05, all); multivariate regression showed that serum triglyceride was the most significantly positive factor associated to GBC (P < 0.001, all) among the hazard factors including serum TG, LDL-c levels, HOMA-IR. In non-GSD ones, multivariate regression showed that HOMA-IR was the most significantly positive factor associated to GBC among the hazard factors including serum TG, LDL-c levels, HOMA-IR, female being, while DM had a significantly inversion negative association (P < 0.001). CONCLUSION We found initially that elevated serum TG levels could be the most remarkable independent predicting factor for GBC risk with GSD, while insulin resistance might act as the first one in non-GSD. More importantly, we advocated initially the sharp rise of serum TG levels as the potential of a candidate diagnostic or prognostic biomarker of GBC with GSD. TRIAL REGISTRATION The study may be performed in accordance with the ethical standards provided by the responsible committee of our institution (First Affiliated Hospital of Xi'an Jiaotong University. XJTU1AF2020LSK-160) at which the work was carried out an in accordance with the Declaration of Helsinki. The ethics committee of our institution strictly comply with the requirements of ICH-GCP、GCP and relevant regulations to construct, operate and implement operating procedures.
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Affiliation(s)
- Yong Wan
- Department of Geriatric Surgery, First Affiliated Hospital of Xi'an Jiaotong University, No 277 West Yanta Road, Xi'an, China
| | - Jianqin Zhang
- Shaanxi Nutrition Society, Medical School, of Xi'an Jiaotong University Xi'an, Shaanxi, China
| | - Min Chen
- Biobank, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Mao Ma
- Department of Geriatric Surgery, First Affiliated Hospital of Xi'an Jiaotong University, No 277 West Yanta Road, Xi'an, China
| | - Binwu Sheng
- Department of Geriatric Surgery, First Affiliated Hospital of Xi'an Jiaotong University, No 277 West Yanta Road, Xi'an, China.
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Mhatre S, Lacey B, Sherliker P, Chatterjee N, Rajaraman P, Goel M, Patkar S, Ostwal V, Patil P, Shrikhande SV, Chitkara G, Badwe R, Lewington S, Dikshit R. Reproductive factors and gall-bladder cancer, and the effect of common genetic variants on these associations: a case-control study in India. Int J Epidemiol 2022; 51:789-798. [PMID: 34550362 PMCID: PMC9189936 DOI: 10.1093/ije/dyab197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 09/07/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In India, as elsewhere, the incidence of gall-bladder cancer (GBC) is substantially higher in women than in men. Yet, the relevance of reproductive factors to GBC remains poorly understood. METHODS We used logistic regression adjusted for age, education and area to examine associations between reproductive factors and GBC risk, using 790 cases of histologically confirmed GBC and group-matched 1726 visitor controls. We tested the interaction of these associations by genetic variants known to increase the risk of GBC. RESULTS Parity was strongly positively associated with GBC risk: each additional pregnancy was associated with an ∼25% higher risk {odds ratio [OR] 1.26 [95% confidence interval (95% CI) 1.17-1.37]}. After controlling for parity, GBC risk was weakly positively associated with later age of menarche [postmenopausal women, OR 1.11 (95% CI 1.00-1.22) per year], earlier menopause [OR 1.03 (95% CI 1.00-1.06) per year] and shorter reproductive lifespan [OR 1.04 (95% CI 1.01-1.07) per year], but there was little evidence of an association with breastfeeding duration or years since last pregnancy. Risk alleles of single-nucleotide polymorphisms in the ABCB4 and ABCB1 genetic regions had a multiplicative effect on the association with parity, but did not interact with other reproductive factors. CONCLUSIONS We observed higher GBC risk with higher parity and shorter reproductive lifespan, suggesting an important role for reproductive and hormonal factors.
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Affiliation(s)
- Sharayu Mhatre
- Section of Molecular Epidemiology and Population Genetics, Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Ben Lacey
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Paul Sherliker
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Nilanjan Chatterjee
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
- Department of Biostatistics, Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, USA
- Department of Oncology, School of Medicine, John Hopkins University, Baltimore, MD, USA
| | - Preetha Rajaraman
- Office of Global Affairs, Department of Health and Human Services, Washington, DC, USA
| | - Mahesh Goel
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Shraddha Patkar
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Vikas Ostwal
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Prachi Patil
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Medical Gastroenterology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Shailesh V Shrikhande
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Garvit Chitkara
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Rajendra Badwe
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Sarah Lewington
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Rajesh Dikshit
- Section of Molecular Epidemiology and Population Genetics, Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
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Dutta EK, Lewis MG, Albert S. Risk factors associated with gall bladder cancer in high incidence areas in India: a systematic review protocol. BMJ Open 2022; 12:e056849. [PMID: 35232789 PMCID: PMC8889324 DOI: 10.1136/bmjopen-2021-056849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Gall bladder cancer (GBC) is a lethal form of malignancy of the gastrointestinal tract with a unique geographical distribution. Cases are aggregated in the river basins of Ganga-Brahmaputra, in the north, east and north-east India, collectively termed as the 'high-risk' zone for GBC. Although some studies report high prevalence of typhoid infection linking with high burden of GBC in these regions, there is no systematic review of the factors associated with GBC in the high incidence areas. To address this gap, we are conducting a systematic review to identify and organise the factors associated with GBC in the high-risk zone of India. METHODS AND ANALYSIS A systematic review of all observational studies that report a quantitative relationship between at least one risk factor for GBC among adults (>18 years) in the high-risk zone in India will be conducted. The databases PubMed-MEDLINE, CINAHL, EMBASE, Web of Science, Scopus, OpenGrey and Google Scholar published in English and after 1990 will be searched. This review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. The primary outcome is GBC. If data permit, meta-analysis will be performed. Two independent reviewers will independently screen the articles, extract the data and assess the methodological quality of the studies. ETHICS AND DISSEMINATION As this will be a systematic review without human participants' involvement, there will be no requirement for ethics approval. Findings will be disseminated widely through peer-reviewed publication and media, for example, conferences and symposia. PROSPERO REGISTRATION NUMBER CRD42021256673.
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Affiliation(s)
- Eliza K Dutta
- Indian Institutes of Public Health, Shillong, Meghalaya, India
| | | | - Sandra Albert
- Indian Institutes of Public Health, Shillong, Meghalaya, India
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Chavan S, Rathi P. Gallbladder Polyp: Review and Proposed Algorithm for Management. J Assoc Physicians India 2022; 70:11-12. [PMID: 35062812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Gall bladder polyp is a lesion which is often an incidentally reported finding on ultrasonography. Such patients may or may not have symptoms of gall bladder disease. Although majority of polyps are cholesterol polyps, some are malignant. The challenge is early detection of malignant polyp and cholecystectomy before it becomes invasive or if invasive to carry out adequately wide surgical excision; while avoiding surgery in asymptomatic patients with benign disease. Following are the characteristics suggestive of malignancy in polyp: - size more than 10 mm, solitary lesions, increase in size over time, adenomatous polyps, sessile lesions and associated gallbladder wall thickening. Incidence of malignancy is higher in patients with Indian ethnicity, age more than 50 years, associated primary sclerosing cholangitis or gall stone disease. Pre-operative tissue diagnosis is difficult to obtain and review ultrasonography, contrast enhanced CT scan, endo sonography and a regular follow-up can help the surgeon take the appropriate decision.
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Affiliation(s)
- Swati Chavan
- Gastroenterology Resident, Bombay Hospital & Medical Research Centre, Mumbai, Maharashtra
| | - Pravin Rathi
- Professor and Head, Department of Gastroenterology, B.Y.L. Nair Charitable Hospital and T.N. Medical College, Mumbai, Maharashtra
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Rosato V, Gómez-Rubio P, Molina-Montes E, Márquez M, Löhr M, O'Rorke M, Michalski CW, Molero X, Farré A, Perea J, Kleeff J, Crnogorac-Jurcevic T, Greenhalf W, Ilzarbe L, Tardón A, Gress T, Barberá VM, Domínguez-Muñoz E, Muñoz-Bellvís L, Balsells J, Costello E, Iglesias M, Kong B, Mora J, O'Driscoll D, Poves I, Scarpa A, Ye W, Hidalgo M, Sharp L, Carrato A, Real FX, La Vecchia C, Malats N. Gallbladder disease and pancreatic cancer risk: a multicentric case-control European study. Eur J Cancer Prev 2021; 30:423-430. [PMID: 34545020 DOI: 10.1097/cej.0000000000000588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS The overall evidence on the association between gallbladder conditions (GBC: gallstones and cholecystectomy) and pancreatic cancer (PC) is inconsistent. To our knowledge, no previous investigations considered the role of tumour characteristics on this association. Thus, we aimed to assess the association between self-reported GBC and PC risk, by focussing on timing to PC diagnosis and tumour features (stage, location, and resection). METHODS Data derived from a European case-control study conducted between 2009 and 2014 including 1431 PC cases and 1090 controls. We used unconditional logistic regression models to estimate odds ratios (ORs) and corresponding 95% confidence intervals (CIs) adjusted for recognized confounders. RESULTS Overall, 298 (20.8%) cases and 127 (11.6%) controls reported to have had GBC, corresponding to an OR of 1.70 (95% CI 1.33-2.16). The ORs were 4.84 (95% CI 2.96-7.89) for GBC diagnosed <3 years before PC and 1.06 (95% CI 0.79-1.41) for ≥3 years. The risk was slightly higher for stage I/II (OR = 1.71, 95% CI 1.15-2.55) vs. stage III/IV tumours (OR = 1.23, 95% CI 0.87-1.76); for tumours sited in the head of the pancreas (OR = 1.59, 95% CI 1.13-2.24) vs. tumours located at the body/tail (OR = 1.02, 95% CI 0.62-1.68); and for tumours surgically resected (OR = 1.69, 95% CI 1.14-2.51) vs. non-resected tumours (OR = 1.25, 95% CI 0.88-1.78). The corresponding ORs for GBC diagnosed ≥3 years prior PC were close to unity. CONCLUSION Our study supports the association between GBC and PC. Given the time-risk pattern observed, however, this relationship may be non-causal and, partly or largely, due to diagnostic attention and/or reverse causation.
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Affiliation(s)
- V Rosato
- Unit of Medical Statistics and Biometry, National Cancer Institute, IRCCS Foundation, Milan, Italy
| | - P Gómez-Rubio
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid
- CIBERONC, Spain
| | - E Molina-Montes
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid
- CIBERONC, Spain
| | - M Márquez
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid
- CIBERONC, Spain
| | - M Löhr
- Gastrocentrum, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - M O'Rorke
- Centre for Public Health, Belfast, Queen's University Belfast, Belfast, UK
| | - C W Michalski
- Department of Surgery, Technical University of Munich, Munich
- Department of Visceral, Vascular and Endocrine Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - X Molero
- Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Barcelona, Universitat Autònoma de Barcelona, Barcelona
- CIBEREHD
| | - A Farré
- Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona
| | - J Perea
- Department of Surgery, University Hospital 12 de Octubre
- Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - J Kleeff
- Department of Surgery, Technical University of Munich, Munich
- Department of Visceral, Vascular and Endocrine Surgery, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - T Crnogorac-Jurcevic
- Barts Cancer Institute, Centre for Molecular Oncology, Queen Mary University of London, John Vane Science Centre, London
| | - W Greenhalf
- Department of Molecular and Clinical Cancer Medicine, The Royal Liverpool University Hospital, Liverpool, UK
| | - L Ilzarbe
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid
- Hospital del Mar-Parc de Salut Mar, Barcelona
| | - A Tardón
- Department of Medicine, Instituto Universitario de Oncología del Principado de Asturias, Oviedo
- CIBERESP, Spain
| | - T Gress
- Department of Gastroenterology, University Hospital of Giessen and Marburg, Marburg, Germany
| | - V M Barberá
- Molecular Genetics Laboratory, General University Hospital of Elche
| | - E Domínguez-Muñoz
- Department of Gastroenterology, University Clinical Hospital of Santiago de Compostela
| | - L Muñoz-Bellvís
- General and Digestive Surgery Department, Salamanca University Hospital, Elche, Santiago de Compostela, and Salamanca, Spain
| | - J Balsells
- Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Barcelona, Universitat Autònoma de Barcelona, Barcelona
- CIBEREHD
| | - E Costello
- Department of Molecular and Clinical Cancer Medicine, The Royal Liverpool University Hospital, Liverpool, UK
| | - M Iglesias
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid
- Hospital del Mar-Parc de Salut Mar, Barcelona
| | - Bo Kong
- Department of Surgery, Technical University of Munich, Munich
| | - J Mora
- Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona
| | - D O'Driscoll
- National Cancer Registry Ireland and HRB Clinical Research Facility, University College Cork, Cork, Ireland
| | - I Poves
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid
- Hospital del Mar-Parc de Salut Mar, Barcelona
| | - A Scarpa
- ARC-Net centre for Applied Research on Cancer and Department of Pathology and Diagnostics, University and Hospital trust of Verona, Verona, Italy
| | - W Ye
- Gastrocentrum, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - M Hidalgo
- Madrid-Norte-Sanchinarro Hospital, Madrid, Spain
| | - L Sharp
- National Cancer Registry Ireland and HRB Clinical Research Facility, University College Cork, Cork, Ireland
- Newcastle University, Institute of Health & Society, Newcastle, UK
| | - A Carrato
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid
- Department of Oncology, Ramón y Cajal University Hospital, IRYCIS, Alcala University
| | - F X Real
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid
- Epithelial Carcinogenesis Group
- Spanish National Cancer Research Centre (CNIO), Madrid
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain
| | - C La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - N Malats
- Genetic and Molecular Epidemiology Group, Spanish National Cancer Research Center (CNIO), Madrid
- CIBERONC, Spain
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Xiao Y, Cattelan L, Lagacé F, Ghazawi FM, Alakel A, Grose E, Le M, Nechaev V, Sasseville D, Waschke K, Litvinov IV. Epidemiologic trends and geographic distribution of patients with gallbladder and extrahepatic biliary tract cancers in Canada. HPB (Oxford) 2021; 23:1541-1549. [PMID: 33863655 DOI: 10.1016/j.hpb.2021.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 02/20/2021] [Accepted: 03/07/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Gallbladder and biliary tract cancers are rare malignancies that carry a poor prognosis. Research on their epidemiologic trends is scarce. METHODS We performed a retrospective analysis of the data in Canada using population-based cancer registries from 1992 to 2010. The incidence and mortality of gallbladder and extrahepatic bile duct cancers were examined at the levels of provinces/territories, cities, and Forward Sortation Area (FSA) postal codes. RESULTS The incidence and mortality rates decreased over the study period. The average national incidence rate of gallbladder and biliary tract cancers was 30.92 cases per million individuals per year. Higher than average incidence rates were observed in Manitoba, Saskatchewan and Québec; there were contiguous regions with high incidence in Saskatchewan and Manitoba that suggest an area of putative case clustering. Higher incidence of gallbladder cancer was observed in women, whereas higher incidence of extrahepatic bile duct cancers was noted in men. Lower socioeconomic status and Hispanic race were found to be risk factors for gallbladder and biliary tract cancers. CONCLUSION This is the first study to analyze the burden of gallbladder and biliary tract cancers in Canada. The geographic clustering trends present new avenues for research on environmental triggers.
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Affiliation(s)
- Yasi Xiao
- Division of Internal Medicine, McGill University, Montréal, Québec, Canada; Department of Medicine, McGill University, Montréal, Québec, Canada
| | - Leila Cattelan
- Department of Medicine, McGill University, Montréal, Québec, Canada; Division of Dermatology, McGill University, Montréal, Québec, Canada
| | - Francois Lagacé
- Department of Medicine, McGill University, Montréal, Québec, Canada; Division of Dermatology, McGill University, Montréal, Québec, Canada
| | - Feras M Ghazawi
- Division of Dermatology, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Akram Alakel
- Division of Dermatology, McGill University, Montréal, Québec, Canada
| | - Elysia Grose
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Michelle Le
- Department of Medicine, McGill University, Montréal, Québec, Canada; Division of Dermatology, McGill University, Montréal, Québec, Canada
| | | | - Denis Sasseville
- Division of Dermatology, McGill University, Montréal, Québec, Canada
| | - Kevin Waschke
- Department of Medicine, McGill University, Montréal, Québec, Canada; Division of Gastroenterology, McGill University, Montréal, Québec, Canada.
| | - Ivan V Litvinov
- Department of Medicine, McGill University, Montréal, Québec, Canada; Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
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30
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Barahona Ponce C, Scherer D, Brinster R, Boekstegers F, Marcelain K, Gárate-Calderón V, Müller B, de Toro G, Retamales J, Barajas O, Ahumada M, Morales E, Rojas A, Sanhueza V, Loader D, Rivera MT, Gutiérrez L, Bernal G, Ortega A, Montalvo D, Portiño S, Bertrán ME, Gabler F, Spencer L, Olloquequi J, Fischer C, Jenab M, Aleksandrova K, Katzke V, Weiderpass E, Bonet C, Moradi T, Fischer K, Bossers W, Brenner H, Hveem K, Eklund N, Völker U, Waldenberger M, Fuentes Guajardo M, Gonzalez-Jose R, Bedoya G, Bortolini MC, Canizales-Quinteros S, Gallo C, Ruiz-Linares A, Rothhammer F, Lorenzo Bermejo J. Gallstones, Body Mass Index, C-Reactive Protein, and Gallbladder Cancer: Mendelian Randomization Analysis of Chilean and European Genotype Data. Hepatology 2021; 73:1783-1796. [PMID: 32893372 DOI: 10.1002/hep.31537] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 07/10/2020] [Accepted: 07/31/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIMS Gallbladder cancer (GBC) is a neglected disease with substantial geographical variability: Chile shows the highest incidence worldwide, while GBC is relatively rare in Europe. Here, we investigate the causal effects of risk factors considered in current GBC prevention programs as well as C-reactive protein (CRP) level as a marker of chronic inflammation. APPROACH AND RESULTS We applied two-sample Mendelian randomization (MR) using publicly available data and our own data from a retrospective Chilean and a prospective European study. Causality was assessed by inverse variance weighted (IVW), MR-Egger regression, and weighted median estimates complemented with sensitivity analyses on potential heterogeneity and pleiotropy, two-step MR, and mediation analysis. We found evidence for a causal effect of gallstone disease on GBC risk in Chileans (P = 9 × 10-5 ) and Europeans (P = 9 × 10-5 ). A genetically elevated body mass index (BMI) increased GBC risk in Chileans (P = 0.03), while higher CRP concentrations increased GBC risk in Europeans (P = 4.1 × 10-6 ). European results suggest causal effects of BMI on gallstone disease (P = 0.008); public Chilean data were not, however, available to enable assessment of the mediation effects among causal GBC risk factors. CONCLUSIONS Two risk factors considered in the current Chilean program for GBC prevention are causally linked to GBC risk: gallstones and BMI. For Europeans, BMI showed a causal effect on gallstone risk, which was itself causally linked to GBC risk.
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Affiliation(s)
- Carol Barahona Ponce
- Statistical Genetics Group, Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
- Department of Basic and Clinical Oncology, Medical Faculty, University of Chile, Santiago de Chile, Chile
| | - Dominique Scherer
- Statistical Genetics Group, Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Regina Brinster
- Statistical Genetics Group, Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Felix Boekstegers
- Statistical Genetics Group, Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Katherine Marcelain
- Department of Basic and Clinical Oncology, Medical Faculty, University of Chile, Santiago de Chile, Chile
| | - Valentina Gárate-Calderón
- Statistical Genetics Group, Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
- Department of Basic and Clinical Oncology, Medical Faculty, University of Chile, Santiago de Chile, Chile
| | - Bettina Müller
- Servicio de Oncología Médica, Instituto Nacional del Cáncer, Santiago, Chile
| | - Gonzalo de Toro
- Escuela de Tecnologia Medica, Universidad Austral de Chile sede Puerto Montt, Puerto Montt, Chile
- Servicio de Anatomía Patológica, Hospital de Puerto Montt, Puerto Montt, Chile
| | - Javier Retamales
- Servicio de Oncología Médica, Instituto Nacional del Cáncer, Santiago, Chile
| | - Olga Barajas
- Department of Basic and Clinical Oncology, Medical Faculty, University of Chile, Santiago de Chile, Chile
- Department of Basic and Clinical Oncology, Medical Faculty, University of Chile, Santiago, Chile
- Oncology Department, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Monica Ahumada
- Department of Basic and Clinical Oncology, Medical Faculty, University of Chile, Santiago de Chile, Chile
- Department of Basic and Clinical Oncology, Medical Faculty, University of Chile, Santiago, Chile
- Oncology Department, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Erik Morales
- Facultad de Medicina, Universidad Católica del Maule, Talca, Chile
- Unidad de Anatomía Patológica del Hospital Regional de Talca, Talca, Chile
| | - Armando Rojas
- Laboratorio de Investigaciones Biomédicas en la Facultad de Medicina, Universidad Católica del Maule, Talca, Chile
| | - Verónica Sanhueza
- Servicio de Anatomía Patológica, Hospital Padre Hurtado, Santiago, Chile
| | - Denisse Loader
- Servicio de Anatomía Patológica, Hospital Padre Hurtado, Santiago, Chile
| | | | - Lorena Gutiérrez
- Servicio de Anatomía Patológica, Hospital San Juan de Dios, Santiago, Chile
| | - Giuliano Bernal
- Laboratory of Molecular and Cellular Biology of Cancer (CancerLab), Department of Biomedical Sciences, Faculty of Medicine, Universidad Católica del Norte, Coquimbo, Chile
| | - Alejandro Ortega
- Servicio de Anatomía Patológica, Hospital Regional, Arica, Chile
| | | | - Sergio Portiño
- Department of Basic and Clinical Oncology, Medical Faculty, University of Chile, Santiago, Chile
- Oncology Department, Hospital Clínico Universidad de Chile, Santiago, Chile
| | | | - Fernando Gabler
- Servicio de Anatomía Patológica, Hospital San Borja Arriarán, Santiago, Chile
| | - Loreto Spencer
- Servicio de Anatomía Patológica, Hospital Regional Guillermo Grant Benavente, Concepción, Chile
| | - Jordi Olloquequi
- Laboratory of Cellular and Molecular Pathology, Instituto de Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Christine Fischer
- Institute of Human Genetics, University of Heidelberg, Heidelberg, Germany
| | - Mazda Jenab
- International Agency for Research on Cancer, Lyon, France
| | - Krasimira Aleksandrova
- Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany
| | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Catalina Bonet
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Barcelona, Spain
| | - Tahereh Moradi
- Division of Epidemiology, Department of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Krista Fischer
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia
| | | | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center, National Center for Tumor Diseases, Heidelberg, Germany
- German Cancer Consortium, German Cancer Research Center, Heidelberg, Germany
| | - Kristian Hveem
- The Nord-Trøndelag Health Research Centre, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Public Health and Nursing, K.G. Jebsen Centre for Genetic Epidemiology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Niina Eklund
- Genomics and Biobank, National Institute for Health and Welfare, Helsinki, Finland
| | - Uwe Völker
- Interfakultäres Institut für Genetik und Funktionelle Genomforschung, Universitätsmedizin Greifswald, Germany
| | - Melanie Waldenberger
- Research Unit of Molecular Epidemiology and Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | | | - Rolando Gonzalez-Jose
- Centro Nacional Patagónico, Instituto Patagónico de Ciencias Sociales y Humanas, CONICET, Puerto Madryn, Argentina
| | - Gabriel Bedoya
- Facultad de Ciencias Exactas y Naturales, Universidad de Antioquia, Medellín, Colombia
| | - Maria C Bortolini
- Instituto de Biociências, Universidad Federal do Rio Grande do Sul, Puerto Alegre, Brazil
| | | | - Carla Gallo
- Unidad de Neurobiología Molecular y Genética, Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Andres Ruiz-Linares
- Ministry of Education Key Laboratory of Contemporary Anthropology and Collaborative Innovation Center of Genetics and Development, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
- Aix-Marseille Université, CNRS, EFS, ADES, Marseille, France
- Department of Genetics, Evolution and Environment, and UCL Genetics Institute, University College London, London, UK
| | | | - Justo Lorenzo Bermejo
- Statistical Genetics Group, Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
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31
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Ren T, Li Y, Zhang X, Geng Y, Shao Z, Li M, Wu X, Wang XA, Liu F, Wu W, Shu Y, Bao R, Gong W, Dong P, Dang X, Liu C, Liu C, Sun B, Liu J, Wang L, Hong D, Qin R, Jiang X, Zhang X, Xu J, Jia J, Yang B, Li B, Dai C, Cao J, Cao H, Tao F, Zhang Z, Wang Y, Jin H, Cai H, Fei Z, Gu J, Han W, Feng X, Fang L, Zheng L, Zhu C, Wang K, Zhang X, Li X, Jin C, Qian Y, Cui Y, Xu Y, Wang X, Liu H, Hua Y, Liu C, Hao J, Wang C, Li Q, Li X, Liu J, Li M, Qiu Y, Wu B, Zheng J, Chen X, Zhu H, Hua K, Yan M, Wang P, Zang H, Ma X, Hong J, Liu Y. Protocol for a gallbladder cancer registry study in China: the Chinese Research Group of Gallbladder Cancer (CRGGC) study. BMJ Open 2021; 11:e038634. [PMID: 33593763 PMCID: PMC7888310 DOI: 10.1136/bmjopen-2020-038634] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Gallbladder cancer (GBC), the sixth most common gastrointestinal tract cancer, poses a significant disease burden in China. However, no national representative data are available on the clinical characteristics, treatment and prognosis of GBC in the Chinese population. METHODS AND ANALYSIS The Chinese Research Group of Gallbladder Cancer (CRGGC) study is a multicentre retrospective registry cohort study. Clinically diagnosed patient with GBC will be identified from 1 January 2008 to December, 2019, by reviewing the electronic medical records from 76 tertiary and secondary hospitals across 28 provinces in China. Patients with pathological and radiological diagnoses of malignancy, including cancer in situ, from the gallbladder and cystic duct are eligible, according to the National Comprehensive Cancer Network 2019 guidelines. Patients will be excluded if GBC is the secondary diagnosis in the discharge summary. The demographic characteristics, medical history, physical examination results, surgery information, pathological data, laboratory examination results and radiology reports will be collected in a standardised case report form. By May 2021, approximately 6000 patient with GBC will be included. The clinical follow-up data will be updated until 5 years after the last admission for GBC of each patient. The study aimed (1) to depict the clinical characteristics, including demographics, pathology, treatment and prognosis of patient with GBC in China; (2) to evaluate the adherence to clinical guidelines of GBC and (3) to improve clinical practice for diagnosing and treating GBC and provide references for policy-makers. ETHICS AND DISSEMINATION The protocol of the CRGGC has been approved by the Committee for Ethics of Xinhua Hospital, Shanghai Jiao Tong University School of Medicine (SHEC-C-2019-085). All results of this study will be published in peer-reviewed journals and presented at relevant conferences. TRIAL REGISTRATION NUMBER NCT04140552, Pre-results.
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Affiliation(s)
- Tai Ren
- Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai, China
| | - Yongsheng Li
- Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai, China
- Department of Biliary-Pancreatic Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, China
| | - Xi Zhang
- Clinical Research Unit, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yajun Geng
- Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai, China
| | - Ziyu Shao
- Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai, China
| | - Maolan Li
- Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai, China
| | - Xiangsong Wu
- Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai, China
| | - Xu-An Wang
- Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai, China
- Department of Biliary-Pancreatic Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, China
| | - Fatao Liu
- Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai, China
| | - Wenguang Wu
- Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai, China
- Department of Biliary-Pancreatic Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, China
| | - Yijun Shu
- Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai, China
| | - Runfa Bao
- Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai, China
| | - Wei Gong
- Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai, China
| | - Ping Dong
- Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai, China
| | - Xueyi Dang
- Department of General Surgery, Shanxi Provincial Cancer Hospital, Taiyuan, Shanxi, China
| | - Chang Liu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Changjun Liu
- Department of Hepatobiliary Surgery, People's Hospital of Hunan Province, Changsha, Hunan, China
| | - Bei Sun
- Department of HPB Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Jun Liu
- Department of Hepatobiliary Surgery, Shandong Provincial Hospital, Jinan, Shandong, China
| | - Lin Wang
- Department of Hepatobiliary Surgery, Xijing Hospital, Xi'an, Shaanxi, China
| | - Defei Hong
- Department of HPB Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Renyi Qin
- Department of Pancreatobiliary Surgery, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaoqing Jiang
- Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Shanghai, China
| | - Xuewen Zhang
- Department of HPB Surgery, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Junmin Xu
- Department of General Surgery, Shanghai General Hospital, Shanghai, China
| | - Jianguang Jia
- Department of Surgical Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Bo Yang
- Department of General Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Bing Li
- Department of HPB Surgery, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Chaoliu Dai
- Department of Hepatobiliary Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Jingyu Cao
- Department of HPB Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Hong Cao
- Department of GI Surgery, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Feng Tao
- Department of GI Surgery, Shaoxing People's Hospital, Shaoxing, Zhejiang, China
| | - Zaiyang Zhang
- Department of General Surgery, Shaoxing Second Hospital, Shaoxing, Zhejiang, China
| | - Yi Wang
- Department of GI Surgery, The First People's Hospital of Taicang, Taicang, Jiangsu, China
| | - Huihan Jin
- Department of Hepatobiliary Surgery, Wuxi Second People's Hospital, Wuxi, Jiangsu, China
| | - Hongyu Cai
- Department of Hepatobiliary Surgery, Nantong Tumor Hospital, Nantong, Jiangsu, China
| | - Zhewei Fei
- Department of General Surgery, Shanghai Jiaotong University School of Medicine Xinhua Hospital Chongming Branch, Shanghai, China
| | - Jianfeng Gu
- Department of General Surgery, Changshu No. 1 People's Hospital, Changshu, Jiangsu, China
| | - Wei Han
- Department of Pancreatic Surgery, The First People's Hospital of Taicang, Urumqi, Xinjiang, China
| | - Xuedong Feng
- Department of General Surgery, Tongliao City Hospital, Inner Mongolia, Tongliao, China
| | - Lu Fang
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Linhui Zheng
- Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Chunfu Zhu
- Department of HPB Surgery, Changzhou No. 2 People's Hospital, Changzhou, Jiangsu, China
| | - Kunhua Wang
- Department of General Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Xueli Zhang
- Department of General Surgery, Shanghai Fengxian District Central Hospital, Shanghai, Shanghai, China
| | - Xiaoyong Li
- Department of HPB Surgery, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Chong Jin
- Department of General Surgery, Taizhou Municipal Hospital, Taizhou, Zhejiang, China
| | - Yeben Qian
- Department of HPB Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yunfu Cui
- Department of Pancreatobiliary Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yuzhen Xu
- Department of GI Surgery, Xuzhou Central Hospital, Xuzhou, Jiangsu, China
| | - Xiang Wang
- Department of HPB Surgery, Xinghua City People's Hospital, Taizhou, Jiangsu, China
| | - Houbao Liu
- Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yawei Hua
- Department of General Surgery, Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Chao Liu
- Department of Pancreatobiliary Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Jihui Hao
- Department of Pancreatic Surgery, Tianjin Medical University Cancer Hospital, Tianjin, China
| | - Chuanlei Wang
- Department of HPB Surgery, The First Bethune Hospital of Jilin University, Changchun, Jilin, China
| | - Qiyun Li
- Department of Abdominal Surgery, Jiangxi Cancer Hospital, Nanchang, Jiangxi, China
| | - Xun Li
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Jiansheng Liu
- Department of General Surgery, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Mingzhang Li
- Department of General Surgery, Baotou City Central Hospital, Baotou, Inner Mongolia, China
| | - Yudong Qiu
- Department of Pancreatobiliary Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Buqiang Wu
- Department of General Surgery, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China
| | - Jinfang Zheng
- Department of General Surgery, Hainan Provincial People's Hospital, Haikou, Hainan, China
| | - Xiaoliang Chen
- Department of Hepatobiliary Surgery, Jiangxi Provincial People's Hospital, Nanchang, Jiangxi, China
| | - Haihong Zhu
- Department of General Surgery, Qinghai Provincial People's Hospital, Xining, Qinghai, China
| | - Kejun Hua
- Department of General Surgery, Yinzhou Hospital Affiliated to Medical School of Ningbo University, Ningbo, Zhejiang, China
| | - Maolin Yan
- Department of Hepatobiliary Surgery, Fujian Provincial Hospital, Fuzhou, Fujian, China
| | - Peng Wang
- Department of HPB Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Hong Zang
- Department of Hepatobiliary Surgery, The First People's Hospital of Nantong, Nantong, Jiangsu, China
| | - Xiaoming Ma
- Department of General Surgery, The Second Affiliated Hospital of Suzhou University, Suzhou, Jiangsu, China
| | - Jian Hong
- Department of General Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yingbin Liu
- Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai, China
- Department of Biliary-Pancreatic Surgery, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, China
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Koshiol J, Van De Wyngard V, McGee EE, Cook P, Pfeiffer RM, Mardones N, Medina K, Olivo V, Pettit K, Jackson SS, Paredes F, Sanchez R, Huidobro A, Villaseca M, Bellolio E, Losada H, Roa JC, Hildesheim A, Araya JC, Ferreccio C. The Chile Biliary Longitudinal Study: A Gallstone Cohort. Am J Epidemiol 2021; 190:196-206. [PMID: 33524121 DOI: 10.1093/aje/kwaa199] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 12/14/2022] Open
Abstract
Gallbladder cancer (GBC) is a highly fatal cancer that can be cured through cholecystectomy if identified early. The presence of gallstones is the primary risk factor for GBC, but few people with gallstones develop GBC. A key question is what drives the development of GBC among persons with gallstones. We initiated the Chile Biliary Longitudinal Study (Chile BiLS) to address this question. From 2016 to 2019, Chile BiLS enrolled 4,726 women aged 50-74 years with ultrasound-detected gallstones from southern-central Chile, accounting for an estimated 36% of eligible women with gallstones in the study area. The median age was 59 years; 25% of the women were Amerindian (Mapuche), 60% were obese, 25% had diabetes, and 6% had cardiovascular disease. Participants will be followed for gallbladder dysplasia or cancer for 6 years. As of April 30, 2020, over 91% of those eligible completed the year 2 follow-up visit. Data being collected include epidemiologic and sociodemographic information, anthropometric measurements, blood pressure, and tooth counts. Biosamples being taken include baseline plasma, buffy coat, red blood cells, serum, blood clot from serum, and PAXgene whole blood (PreAnalytiX GmbH, Hombrechtikon, Switzerland). Complete gallbladder sampling is conducted for most participants undergoing cholecystectomy. The Chile BiLS cohort study will increase our understanding of GBC etiology and could identify potential risk stratification and early detection strategies in high-risk areas.
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Poudel R, Shah A. Incidence of Incidental Gall Bladder Cancer and Role of Routine Histopathological Examination in Cholecystectomies Specimens for Benign Disease. J Nepal Health Res Counc 2020; 18:547-550. [PMID: 33210657 DOI: 10.33314/jnhrc.v18i3.1974] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 11/14/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Gallbladder cancer is the most common biliary tract cancer. Incidence rate of gall bladder cancer varies worldwide. Most of the patient with gall bladder cancer remained asymptomatic until late. Preoperative early diagnosis of carcinoma of gallbladder is rare, occurring in fewer than 20% of patients. Role of routine histopathology for cholecystectomy specimen is debatable. Aim of this study is to find the incidence of incidental gall bladder cancer and determine whether routine histopathology of cholecystectomy specimen is required or not. METHODS This is a retrospective descriptive study carried out in Universal College of Medical Sciences, Bhairahawha, Nepal. Histopathology reports of all patients who had undergone cholecystectomies from June 2014 to September 2018 were reviewed. Patients' information regarding inpatient number, age, sex, year of diagnosis, preoperative diagnosis, intraoperative findings, histopathology report and pathological staging were recorded. Data were entered and analyzed using Microsoft Excel version 14. RESULTS Total of 418 routine cholecystectomies were performed during this period. Seven cases of incidental gall bladder cancer were diagnosed. None of the patients had preoperative suspicion for malignancy. One patient had intraoperative suspicion of lesion. CONCLUSIONS Incidence of incidental gallbladder cancer is 1.67%. It is recommended that routine histopathology of cholecystectomy specimen should be sent for early diagnosis and improve survival of patient with gall bladder cancer.
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Affiliation(s)
- Rajesh Poudel
- Department of Surgery, Universal College of Medical Sciences, Bhairahawha, Nepal
| | - Anita Shah
- Department of Pathology, Universal College of Medical Sciences, Bhairahawha, Nepal
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Fujiwara K, Masatsugu T, Abe A, Hirano T, Sada M. Preoperative diagnoses and identification rates of unexpected gallbladder cancer. PLoS One 2020; 15:e0239178. [PMID: 32946469 PMCID: PMC7500683 DOI: 10.1371/journal.pone.0239178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/01/2020] [Indexed: 12/16/2022] Open
Abstract
Background Unexpected gallbladder cancer (UGBC) is sometimes found in the resected gallbladder of patients during or after surgery. Some reports have indicated UGBC identification rates for all gallbladder surgeries, but scarce data are available for the UGBC identification rates for specific gallbladder diseases. The present study was performed to clarify UGBC rates and the factors suspicious for UGBC categorized according to preoperative diagnoses, in patients undergoing laparoscopic cholecystectomy (LSC). Methods We recorded data for all LSC surgeries performed in the Department of Surgery, Sada Hospital, Japan since 1991, and analyzed the 28-year data. We used the chi-square test and Kaplan–Meier analysis for this retrospective case–control study. Results The UGBC identification rate was 0.69% (63/9186 patients). The UGBC identification rates categorized according to the preoperative diagnoses were 1.3% (13/969) for acute cholecystitis, 2.4% (16/655) for benign tumor, 2.0% (28/1383) for chronic cholecystitis or cholecystitis, and 0.054% (3/5585) for cholecystolithiasis. The percentage of older patients (≥ 60 years) was significantly higher in UGBCs compared with cases finally diagnosed as benign in each group categorized according to the preoperative diagnoses (p≤0.0014), except for cholecystolithiasis. In cases pre-diagnosed as benign tumor, UGBCs were associated with higher rates of thickened gallbladder wall compared with benign tumor (69.2% vs. 27.9%, respectively; p = 0.0011). UGBCs pre-diagnosed as acute cholecystitis had higher T2–T4 rates (100% vs. 64.3%, respectively; p<0.05) and lower survival rates (p = 0.0149) than UGBCs pre-diagnosed with chronic cholecystitis. Conclusions UGBC identification rates depend on the preoperative diagnosis and range from 0.054% to 2.4%. Older age (≥ 60 years) could be related to UGBC, and a pre-diagnosis of acute cholecystitis might indicate more advanced cancer compared with a pre-diagnosis of chronic cholecystitis.
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Affiliation(s)
- Kenji Fujiwara
- Department of Surgery, Sada Hospital, Fukuoka, Japan
- * E-mail:
| | | | - Atsushi Abe
- Department of Surgery, Sada Hospital, Fukuoka, Japan
| | | | - Masayuki Sada
- Department of Surgery, Sada Hospital, Fukuoka, Japan
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Mhatre S, Rajaraman P, Chatterjee N, Bray F, Goel M, Patkar S, Ostwal V, Patil P, Manjrekar A, Shrikhande SV, Badwe R, Dikshit R. Mustard oil consumption, cooking method, diet and gallbladder cancer risk in high- and low-risk regions of India. Int J Cancer 2020; 147:1621-1628. [PMID: 32142159 DOI: 10.1002/ijc.32952] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/20/2020] [Accepted: 02/24/2020] [Indexed: 03/25/2024]
Abstract
The current study aimed to investigate the role of cooking with mustard oil and other dietary factors in relation to gallbladder cancer (GBC) in high- and low-incidence regions of India. A case-control study was conducted including 1,170 histologically confirmed cases and 2,525 group-matched visitor controls from the largest cancer hospital in India. Dietary data were collected through a food frequency questionnaire. For oil consumption, we enquired about monthly consumption of 11 different types of cooking oil per family and the number of individuals usually sharing the meal to estimate per-individual consumption of oil. Information about method of cooking was also requested. Odds ratios (ORs) and 95% confidence intervals (CIs) quantifying the association of GBC risk consumption of different types of oil, method of cooking, and dietary food items, were estimated using logistic regression models, after adjusting for potential confounders. High consumption of mustard oil was associated with GBC risk in both high- and low-risk regions (OR = 1.33, 95% CI = 0.99-1.78; OR = 3.01, 95% CI = 1.66-5.45), respectively. An increased risk of GBC was observed with deep frying of fresh fish in mustard oil (OR = 1.57, 95% CI = 0.99-2.47, p-value = 0.052). A protective association was observed with consumption of leafy vegetables, fruits, onion and garlic. No association was observed between consumption of meat, spicy food, turmeric, pulses or with any other oil as a cooking medium. The effect of high consumption of mustard oil on GBC risk, if confirmed, has implications for the primary prevention of GBC, via a reduced consumption.
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Affiliation(s)
- Sharayu Mhatre
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, India
- Homi Bhabha national institute (HBNI), Mumbai, India
| | - Preetha Rajaraman
- Office of Global Affairs, Department of Health and Human Services, Washington, District of Columbia, USA
| | - Nilanjan Chatterjee
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
- Department of Biostatistics, Bloomberg School of Public Health, John Hopkins University, Baltimore, Maryland, USA
- Department of Oncology, School of Medicine, John Hopkins University, Baltimore, Maryland, USA
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Mahesh Goel
- Homi Bhabha national institute (HBNI), Mumbai, India
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Shraddha Patkar
- Homi Bhabha national institute (HBNI), Mumbai, India
- Department of Clinical Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Vikas Ostwal
- Homi Bhabha national institute (HBNI), Mumbai, India
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Prachi Patil
- Homi Bhabha national institute (HBNI), Mumbai, India
- Department of Medical Gastroenterology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Ankita Manjrekar
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, India
| | - Shailesh V Shrikhande
- Homi Bhabha national institute (HBNI), Mumbai, India
- Division of Cancer Surgery, GI & HPB Surgical Services, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Rajendra Badwe
- Homi Bhabha national institute (HBNI), Mumbai, India
- Tata Memorial Centre-Surgical Oncology, Mumbai, Maharashtra, India
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai, India
- Homi Bhabha national institute (HBNI), Mumbai, India
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Miranda-Filho A, Piñeros M, Ferreccio C, Adsay V, Soerjomataram I, Bray F, Koshiol J. Gallbladder and extrahepatic bile duct cancers in the Americas: Incidence and mortality patterns and trends. Int J Cancer 2020; 147:978-989. [PMID: 31922259 PMCID: PMC8629410 DOI: 10.1002/ijc.32863] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/17/2019] [Accepted: 12/19/2019] [Indexed: 12/12/2022]
Abstract
Trends in gallbladder cancer incidence and mortality in populations across the Americas can provide insight into shifting epidemiologic patterns and the current and potential impact of preventative and curative programs. Estimates of gallbladder and extrahepatic bile duct cancer incidence and mortality for the year 2018 were extracted from International Agency for Research on Cancer (IARC) GLOBOCAN database for 185 countries. Recorded registry-based incidence from 13 countries was extracted from IARCs Cancer Incidence in Five Continents series and corresponding national deaths from the WHO mortality database. Among females, the highest estimated incidence for gallbladder and extrahepatic bile duct cancer in the Americas were found in Bolivia (21.0 per 100,000), Chile (11.7) and Peru (6.0). In the US, the highest incidence rates were observed among Hispanics (1.8). In the Chilean population, gallbladder cancer rates declined in both females and males between 1998 and 2012. Rates dropped slightly in Canada, Costa Rica, US Whites and Hispanics in Los Angeles. Gallbladder cancer mortality rates also decreased across the studied countries, although rising trends were observed in Colombia and Canada after 2010. Countries within Southern and Central America tended to have a higher proportion of unspecified biliary tract cancers. In public health terms, the decline in gallbladder cancer incidence and mortality rates is encouraging. However, the slight increase in mortality rates during recent years in Colombia and Canada warrant further attention. Higher proportions of unspecified biliary tract cancers (with correspondingly higher mortality rates) suggest more rigorous pathology procedures may be needed after surgery.
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Affiliation(s)
- Adalberto Miranda-Filho
- Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Marion Piñeros
- Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Catterina Ferreccio
- Advanced Center for Chronic Diseases, School of Medicine Pontificia Universidad Católica de Chile, Santiago-Chile
| | - Volkan Adsay
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France
| | - Jill Koshiol
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
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Boekstegers F, Marcelain K, Barahona Ponce C, Baez Benavides PF, Müller B, de Toro G, Retamales J, Barajas O, Ahumada M, Morales E, Rojas A, Sanhueza V, Loader D, Rivera MT, Gutiérrez L, Bernal G, Ortega A, Montalvo D, Portiño S, Bertrán ME, Gabler F, Spencer L, Olloquequi J, González Silos R, Fischer C, Scherer D, Jenab M, Aleksandrova K, Katzke V, Weiderpass E, Moradi T, Fischer K, Bossers W, Brenner H, Hveem K, Eklund N, Völker U, Waldenberger M, Fuentes Guajardo M, Gonzalez-Jose R, Bedoya G, Bortolini MC, Canizales S, Gallo C, Ruiz Linares A, Rothhammer F, Lorenzo Bermejo J. ABCB1/4 gallbladder cancer risk variants identified in India also show strong effects in Chileans. Cancer Epidemiol 2020; 65:101643. [PMID: 32058310 DOI: 10.1016/j.canep.2019.101643] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/08/2019] [Accepted: 11/15/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND The first large-scale genome-wide association study of gallbladder cancer (GBC) recently identified and validated three susceptibility variants in the ABCB1 and ABCB4 genes for individuals of Indian descent. We investigated whether these variants were also associated with GBC risk in Chileans, who show the highest incidence of GBC worldwide, and in Europeans with a low GBC incidence. METHODS This population-based study analysed genotype data from retrospective Chilean case-control (255 cases, 2042 controls) and prospective European cohort (108 cases, 181 controls) samples consistently with the original publication. RESULTS Our results confirmed the reported associations for Chileans with similar risk effects. Particularly strong associations (per-allele odds ratios close to 2) were observed for Chileans with high Native American (=Mapuche) ancestry. No associations were noticed for Europeans, but the statistical power was low. CONCLUSION Taking full advantage of genetic and ethnic differences in GBC risk may improve the efficiency of current prevention programs.
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Affiliation(s)
- Felix Boekstegers
- Statistical Genetics Group, Institute of Medical Biometry and Informatics, University of Heidelberg, Germany
| | - Katherine Marcelain
- Department of Basic and Clinical Oncology, Medical Faculty, University of Chile, Chile
| | - Carol Barahona Ponce
- Statistical Genetics Group, Institute of Medical Biometry and Informatics, University of Heidelberg, Germany; Department of Basic and Clinical Oncology, Medical Faculty, University of Chile, Chile
| | | | - Bettina Müller
- Servicio de Oncología Médica, Instituto Nacional del Cáncer, Santiago, Chile
| | - Gonzalo de Toro
- Servicio de Anatomía Patológica, Hospital de Puerto Montt, Puerto Montt, Chile
| | - Javier Retamales
- Servicio de Oncología Médica, Instituto Nacional del Cáncer, Santiago, Chile
| | - Olga Barajas
- Department of Basic and Clinical Oncology, Medical Faculty, University of Chile, Chile; Oncology, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Monica Ahumada
- Department of Basic and Clinical Oncology, Medical Faculty, University of Chile, Chile; Oncology, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Erik Morales
- Servicio de Anatomía Patológica, Hospital Regional, Talca, Chile
| | - Armando Rojas
- Biomedical Research Labs, Medicine Faculty, Catholic University of Maule, Talca, Chile
| | - Verónica Sanhueza
- Servicio de Anatomía Patológica, Hospital Padre Hurtado, Santiago, Chile
| | - Denisse Loader
- Servicio de Anatomía Patológica, Hospital Padre Hurtado, Santiago, Chile
| | | | - Lorena Gutiérrez
- Servicio de Anatomía Patológica, Hospital San Juan de Dios, Santiago, Chile
| | - Giuliano Bernal
- Laboratory of Molecular and Cellular Biology of Cancer (CancerLab), Department of Biomedical Sciences, Faculty of Medicine, Universidad Católica del Norte, Coquimbo, Chile
| | - Alejandro Ortega
- Servicio de Anatomía Patológica, Hospital Regional, Arica, Chile
| | | | - Sergio Portiño
- Oncology, Hospital Clínico Universidad de Chile, Santiago, Chile
| | | | - Fernando Gabler
- Servicio de Anatomía Patológica, Hospital San Borja Arriarán, Santiago, Chile
| | - Loreto Spencer
- Servicio de Anatomía Patológica, Hospital Regional Guillermo Grant Benavente, Concepción, Chile
| | - Jordi Olloquequi
- Laboratory of Cellular and Molecular Pathology, Instituto de Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Rosa González Silos
- Statistical Genetics Group, Institute of Medical Biometry and Informatics, University of Heidelberg, Germany
| | | | - Dominique Scherer
- Statistical Genetics Group, Institute of Medical Biometry and Informatics, University of Heidelberg, Germany
| | - Mazda Jenab
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Krasimira Aleksandrova
- Nutrition, Immunity and Metabolism Senior Scientist Group, Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany; University of Potsdam, Institute of Nutritional Science, Potsdam, Germany
| | - Verena Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Elisabete Weiderpass
- International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - Tahereh Moradi
- Division of Epidemiology, Department of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Krista Fischer
- Estonian Genome Centre, Institute of Genomics, University of Tartu, Estonia
| | | | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Kristian Hveem
- The Nord-Trøndelag Health (HUNT) Research Centre, Norwegian University of Science and Technology (NTNU), Trondheim, K.G. Jebsen Centre for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Norway
| | - Niina Eklund
- Genomics and biobank, National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Uwe Völker
- Interfakultäres Institut für Genetik und Funktionelle Genomforschung, Universitätsmedizin Greifswald, Germany
| | - Melanie Waldenberger
- Research Unit of Molecular Epidemiology and Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | | | - Rolando Gonzalez-Jose
- Instituto Patagónico de Ciencias Sociales y Humanas, Centro Nacional Patagónico, CONICET, Puerto Madryn, Argentina
| | - Gabriel Bedoya
- Facultad de Ciencias Exactas y Naturales, Universidad de Antioquia, Medellín, Colombia
| | - Maria C Bortolini
- Instituto de Biociências, Universidad Federal do Rio Grande do Sul, Puerto Alegre, Brazil
| | - Samuel Canizales
- Facultad de Química, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Carla Gallo
- Unidad de Neurobiología Molecular y Genética, Laboratorios de Investigación y Desarrollo, Facultad de Ciencias y Filosofía, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Andres Ruiz Linares
- Ministry of Education Key Laboratory of Contemporary Anthropology and Collaborative Innovation Center of Genetics and Development, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai 200433, China; Aix-Marseille Univ, CNRS, EFS, ADES, Marseille 13007, France
| | | | - Justo Lorenzo Bermejo
- Statistical Genetics Group, Institute of Medical Biometry and Informatics, University of Heidelberg, Germany.
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McGee EE, Jackson SS, Petrick JL, Van Dyke AL, Adami HO, Albanes D, Andreotti G, Beane-Freeman LE, Berrington de Gonzalez A, Buring JE, Chan AT, Chen Y, Fraser GE, Freedman ND, Gao YT, Gapstur SM, Gaziano JM, Giles GG, Grant EJ, Grodstein F, Hartge P, Jenab M, Kitahara CM, Knutsen SF, Koh WP, Larsson SC, Lee IM, Liao LM, Luo J, Milne RL, Monroe KR, Neuhouser ML, O’Brien KM, Peters U, Poynter JN, Purdue MP, Robien K, Sandler DP, Sawada N, Schairer C, Sesso HD, Simon TG, Sinha R, Stolzenberg-Solomon R, Tsugane S, Wang R, Weiderpass E, Weinstein SJ, White E, Wolk A, Yuan JM, Zeleniuch-Jacquotte A, Zhang X, Zhu B, McGlynn KA, Campbell PT, Koshiol J. Smoking, Alcohol, and Biliary Tract Cancer Risk: A Pooling Project of 26 Prospective Studies. J Natl Cancer Inst 2019; 111:1263-1278. [PMID: 31127946 PMCID: PMC6910180 DOI: 10.1093/jnci/djz103] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 04/13/2019] [Accepted: 05/15/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Tobacco and alcohol are well-established risk factors for numerous cancers, yet their relationship to biliary tract cancers remains unclear. METHODS We pooled data from 26 prospective studies to evaluate associations of cigarette smoking and alcohol consumption with biliary tract cancer risk. Study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) for associations with smoking and alcohol consumption were calculated. Random-effects meta-analysis produced summary estimates. All statistical tests were two-sided. RESULTS Over a period of 38 369 156 person-years of follow-up, 1391 gallbladder, 758 intrahepatic bile duct, 1208 extrahepatic bile duct, and 623 ampulla of Vater cancer cases were identified. Ever, former, and current smoking were associated with increased extrahepatic bile duct and ampulla of Vater cancers risk (eg, current vs never smokers HR = 1.69, 95% CI = 1.34 to 2.13 and 2.22, 95% CI = 1.69 to 2.92, respectively), with dose-response effects for smoking pack-years, duration, and intensity (all Ptrend < .01). Current smoking and smoking intensity were also associated with intrahepatic bile duct cancer (eg, >40 cigarettes per day vs never smokers HR = 2.15, 95 % CI = 1.15 to 4.00; Ptrend = .001). No convincing association was observed between smoking and gallbladder cancer. Alcohol consumption was only associated with intrahepatic bile duct cancer, with increased risk for individuals consuming five or more vs zero drinks per day (HR = 2.35, 95%CI = 1.46 to 3.78; Ptrend = .04). There was evidence of statistical heterogeneity among several cancer sites, particularly between gallbladder cancer and the other biliary tract cancers. CONCLUSIONS Smoking appears to increase the risk of developing all biliary tract cancers except gallbladder cancer. Alcohol may increase the risk of intrahepatic bile duct cancer. Findings highlight etiologic heterogeneity across the biliary tract.
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Affiliation(s)
- Emma E McGee
- Correspondence to: Emma E. McGee, BA, Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Bethesda, MD 20892 (e-mail: )
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Sábato C, Bastos-Rodrigues L, Moraes DC, Friedman E, De Marco L, Resende V. Genetic Analysis of Brazilian Patients with Gallbladder Cancer. Pathol Oncol Res 2019; 25:811-814. [PMID: 29552713 DOI: 10.1007/s12253-018-0407-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 03/07/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Cristina Sábato
- Department of Surgery, Universidade Federal de Minas Gerais, Av. Alfredo Balena 190, room 114, Belo Horizonte, 30130-100, Brazil
| | | | - Debora Chaves Moraes
- Department of Surgery, Universidade Federal de Minas Gerais, Av. Alfredo Balena 190, room 114, Belo Horizonte, 30130-100, Brazil
| | - Eitan Friedman
- The Susanne Levy Gertner Oncogenetics Unit, Chaim Sheba Medical Center, Tel-Hashomer, Israel
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Luiz De Marco
- Department of Surgery, Universidade Federal de Minas Gerais, Av. Alfredo Balena 190, room 114, Belo Horizonte, 30130-100, Brazil.
| | - Vivian Resende
- Department of Surgery, Universidade Federal de Minas Gerais, Av. Alfredo Balena 190, room 114, Belo Horizonte, 30130-100, Brazil
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Abstract
BACKGROUND The incidence of hepatobiliary cancer is steadily increasing. It is unclear if this rise is related to increasing trends in obesity, metabolic syndrome, and lifestyle changes. METHODS A case-control study was performed using the Health Improvement Network (THIN) database. Cases with a diagnosis of liver, bile duct, and gallbladder cancers were matched in a 1:2 fashion with controls and analyzed for potential associations between hepatobiliary cancer and obesity/metabolic syndrome. RESULTS Four thousand two hundred and eighty-seven patients (62% male, 38% female) with hepatobiliary cancers were matched with 8574 controls. On univariate analysis, body mass index (BMI), smoking, diabetes, alcohol consumption, ischemic heart disease, and hypertension were associated with hepatobiliary cancer. Statin use and non-smoking status had an inverse association. On multivariate analysis, BMI, diabetes, hypertension, ischemic heart disease, and insulin use were associated with the risk of hepatobiliary cancer. Statin use and non-smoking status were protective. On modeling BMI, each of diabetes and hypertension as a single covariate, there was a significant association with hepatobiliary cancer (1.59 [1.49-1.69], p < 0.001) which persisted despite adjusting for increasing age (1.006 [1005-1.006], p < 0.001) and background liver cirrhosis (1.037 [1.03-1.044], p < 0.001). CONCLUSIONS Obesity and metabolic syndrome are associated with the risk of hepatobiliary cancer. Statin use seems to be protective.
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Affiliation(s)
- Shyam Menon
- The Royal Wolverhampton NHS Trust, Wolverhampton, UK.
| | - Ray Mathew
- The Royal Wolverhampton NHS Trust, Wolverhampton, UK
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Dušek L, Mužík J, Krejčí D. Epidemiology of gallbladder and bile duct malignancies in the Czech Republic. Cas Lek Cesk 2019; 158:52-56. [PMID: 31109163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Overview of epidemiology focused on tumors of the bile ducts and gallbladder is based on data of the National Cancer Registry and its newly validated and published data from 2016. In most recent period 2012-2016, 1013 patients were annually (in average) diagnosed with tumors of the bile ducts and gallbladder in the Czech Republic. In the same time, average annual mortality of this disease reached value 836. Prevalence of bile ducts and gallbladder cancer reached 1723 in 2016 and in comparison, with the value measured in 2006, it increased by 28 %. More than 50 % of bile ducts and gallbladder cancers are diagnosed in advanced clinical stages (stage III+) which makes prognosis of patients worse and limits reachable results of therapy.
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Torre LA, Siegel RL, Islami F, Bray F, Jemal A. Worldwide Burden of and Trends in Mortality From Gallbladder and Other Biliary Tract Cancers. Clin Gastroenterol Hepatol 2018; 16:427-437. [PMID: 28826679 DOI: 10.1016/j.cgh.2017.08.017] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 08/10/2017] [Accepted: 08/14/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Gallbladder cancer has a low rate of survival, a unique geographic distribution, and is associated with lifestyle factors that have changed in recent decades. We investigated recent mortality patterns and trends worldwide. METHODS We collected data from the World Health Organization's Cancer Mortality Database to examine sex-specific, age-standardized rates of death from gallbladder and other biliary tract cancers (excluding intrahepatic bile duct cancer; International Classification of Diseases, 9th revision, code 156, or International Classification of Diseases, 10th revision, code C23-24). We compiled cross-sectional rates of mortality from 2009 through 2013 from 50 countries, and also trends over time from 1985 through 2014, using joinpoint regression analysis of data from 45 countries. RESULTS Among women, from 2009 through 2013, there was a 26-fold variation in rates of mortality from gallbladder and other biliary tract cancers; rates ranged from 0.8 deaths per 100,000 in South Africa to 21.2 deaths per 100,000 in Chile. Among men, rates varied 16-fold, from 0.6 deaths per 100,000 in the United Kingdom and Ireland to 9.9 deaths per 100,000 in Chile. Rates of mortality were higher for women than men in 22 of 48 countries for which comparison was possible. Mortality rates are decreasing in most countries, with decreases in the highest-risk populations of 2% or more annually (except Croatia). However, rates continued their long-term increase in Greece, by 1.4% annually in women and 4.7% annually in men from 1985 through 2012, and began increasing in the mid-2000s by 1.9% or more annually in women in the United Kingdom and The Netherlands and in men in Germany. CONCLUSIONS In an analysis of the World Health Organization's Cancer Mortality Database, we found that rates of death from gallbladder and other biliary tract cancers are decreasing in most countries but increasing in some high-income countries following decades of decline. These emerging trends may reflect lifestyle changes, such as increases in excess body weight.
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Affiliation(s)
- Lindsey A Torre
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia.
| | - Rebecca L Siegel
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Farhad Islami
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
| | - Freddie Bray
- Cancer Surveillance Section, International Agency for Research on Cancer, Lyon, France
| | - Ahmedin Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia
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Ka I, Faye M, Diop PS, Faye ABNAC, Ndoye JM, Fall B. [Clinical, epidemiological and therapeutic features of biliary tract cancers: about 20 cases]. Pan Afr Med J 2018; 29:13. [PMID: 29662598 PMCID: PMC5899776 DOI: 10.11604/pamj.2018.29.13.9922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 05/29/2017] [Indexed: 01/03/2023] Open
Abstract
Biliary tract cancers mainly occur in two sites: gallbladder cancer which are adenocarcinomas and intra- and extrahepatic cholangiocarcinomas. We conducted a retrospective study of 20 cases with biliary tract cancer in the Department of Surgery at the General Hospital in Grand-Yoff between January 2006 and October 2014. 40% of patients had gallbladder cancer, 60% of patients had common bile duct cancer. Sex ratio was 1. The average age of patients was 58.1 years. The average time to diagnosis was 3.77 months. Symptomatology was dominated by icteric syndrome and right hypochondrium pain. All patients had biological manifestation of cholestatic syndrome. Abdominal ultrasound was performed in 65% of patients, while abdominal CT scan in 85% of cases and MRI in 35% of cases. Advanced cancers were predominant in our case series (n=19). The majority of patients underwent palliative surgery. The most practiced treatment was biliary diversion (50% of patients). There was a predominance of cholangiocarcinomas. The overall operative morbidity rate was 43.75%. The overall mortality rate in our patients with biliary tract cancers of any site was 31.25%. Median survival was 4 months and a half. Biliary tract cancers have multifaceted features and can be differentiated essentially among intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, gallbladder adenocarcinoma whose evolution is globally different but the prognosis is spontaneously poor.
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Affiliation(s)
- Ibrahima Ka
- Service de Chirurgie Générale, Hôpital Général de Grand-Yoff, Sénégal
| | - Magatte Faye
- Service de Chirurgie Générale, Hôpital Général de Grand-Yoff, Sénégal
| | - Papa Saloum Diop
- Service de Chirurgie Générale, Hôpital Général de Grand-Yoff, Sénégal
| | | | - Jean Marc Ndoye
- Service de Chirurgie Générale, Hôpital Général de Grand-Yoff, Sénégal
| | - Babacar Fall
- Service de Chirurgie Générale, Hôpital Général de Grand-Yoff, Sénégal
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Panebianco A, Laforgia R, Volpi A, Mancarella R, Carbotta G, Punzo C, Lozito C, Tucci R. Predictive factors for incidental gallbladder cancer (IGBC) in patients undergoing cholecystectomy for presumed benign disease. A single-center experience. Ann Ital Chir 2018; 89:118-127. [PMID: 29848815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
AIM The incidence of incidental gallbladder cancer (IGBC) is estimated at 0.3-2.1%. The purpose of our study is to evaluate IGBC incidence in our department and to establish its predictive factors, considering patients' clinical characteristics and pre-operative ultrasound gallbladder features. MATERIAL OF STUDY From January 2012 to December 2015, 434 patients (225 females and 209 males) were enrolled in this retrospective observational study in our General Surgery Department. To analyze potential predictive factors, we divided all the patients into two groups: patients with and without histological diagnosis of IGBC. We focused our attention on the patients' clinical characteristics and preoperative ultrasound gallbladder measurements RESULTS: Seven cases were post-operatively identified as incidental gallbladder cancer (IGBC) and after histological examination an IGBC incidence of 1.6% was encountered. DISCUSSION Considering the increasing numbers of video laparoscopic cholecystectomies (VLC) performed worldwide, cases of IGBC are appearing more frequently. In most cases of IGBC, a second surgical look will be necessary because of feasibility and safety procedures. CONCLUSIONS There is no possibility to establish which risk factors might be predictive for IGBC because of a discordance in the literature and a statistical analysis with low sample size. An accurate surgical procedure needs to be performed to reduce the spread of neoplastic cells and, as a result, improve long-term outcomes. KEY WORDS Incidental Gallbladder cancer, Laparoscopy, Ultrasound.
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Limaiem F, Sassi A, Talbi G, Bouraoui S, Mzabi S. Routine histopathological study of cholecystectomy specimens. Useful? A retrospective study of 1960 cases. Acta Gastroenterol Belg 2017; 80:365-370. [PMID: 29560664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND AIMS Traditionally, a gallbladder removed for presumed benign disease is sent for histopathological examination, but this practice has been the subject of controversy. AIM The aim of this study was to assess the usefulness of routine histopathological examination of cholecystectomy specimens and its impact on the management of patients. PATIENTS AND METHODS The histopathological reports of 1960 patients who underwent cholecystectomy from January 2011 to November 2016 were retrospectively reviewed. Results : There were 519 men and 1441 women (sex-ratio M/F = 0,36) aged between 8 and 96 years (mean = 51,23 years). All patients underwent cholecystectomy (either open or laparoscopic). Histological examination of the surgical specimens showed chronic cholecystitis (n = 1319) (67,29%), acute cholecystitis (n = 117) (5,96%), cholestrolosis (n = 255) (13%), follicular cholecystitis (n = 230) (11,73%), xanthogranulomatous cholecystitis (n = 6) (0,30%), cholesterol polyps (n = 5) (0,255), tubular adenoma (n = 3) (0,15%), mucocele (n = 2) (0,10%), pancreatic heterotopia (n = 2 ) (0,10%), hyperplastic Luschka ducts (n = 2) (0,10%), adenomyoma (n = 2) (0,10%), porcelain calcification (n = 2) (0,10%) and biliary-type adenocarcinoma (n = 9) (0,46%). In 9 cases (0,46%), the gallbladder was histologically normal. CONCLUSION Our study shows that the incidence of pre-malignant and malignant lesions of the gallbladder is very low. We therefore recommend selective histopathological examination of cholecystectomy specimens with abnormal macroscopic findings.
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Affiliation(s)
- Faten Limaiem
- University of Tunis El Manar, Tunis Faculty of Medicine, Tunisia
| | - Asma Sassi
- University of Tunis El Manar, Tunis Faculty of Medicine, Tunisia
| | - Ghofran Talbi
- University of Tunis El Manar, Tunis Faculty of Medicine, Tunisia
| | - Saâdia Bouraoui
- University of Tunis El Manar, Tunis Faculty of Medicine, Tunisia
| | - Sabeh Mzabi
- University of Tunis El Manar, Tunis Faculty of Medicine, Tunisia
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Sharma A, Sharma KL, Gupta A, Yadav A, Kumar A. Gallbladder cancer epidemiology, pathogenesis and molecular genetics: Recent update. World J Gastroenterol 2017; 23:3978-3998. [PMID: 28652652 PMCID: PMC5473118 DOI: 10.3748/wjg.v23.i22.3978] [Citation(s) in RCA: 210] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Revised: 02/01/2017] [Accepted: 06/01/2017] [Indexed: 02/06/2023] Open
Abstract
Gallbladder cancer is a malignancy of biliary tract which is infrequent in developed countries but common in some specific geographical regions of developing countries. Late diagnosis and deprived prognosis are major problems for treatment of gallbladder carcinoma. The dramatic associations of this orphan cancer with various genetic and environmental factors are responsible for its poorly defined pathogenesis. An understanding to the relationship between epidemiology, molecular genetics and pathogenesis of gallbladder cancer can add new insights to its undetermined pathophysiology. Present review article provides a recent update regarding epidemiology, pathogenesis, and molecular genetics of gallbladder cancer. We systematically reviewed published literature on gallbladder cancer from online search engine PubMed (http://www.ncbi.nlm.nih.gov/pubmed). Various keywords used for retrieval of articles were Gallbladder, cancer Epidemiology, molecular genetics and bullion operators like AND, OR, NOT. Cross references were manually searched from various online search engines (http://www.ncbi.nlm.nih.gov/pubmed,https://scholar.google.co.in/, http://www.medline.com/home.jsp). Most of the articles published from 1982 to 2015 in peer reviewed journals have been included in this review.
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Campbell PT, Newton CC, Kitahara CM, Patel AV, Hartge P, Koshiol J, McGlynn KA, Adami HO, Berrington de González A, Beane Freeman LE, Bernstein L, Buring JE, Freedman ND, Gao YT, Giles GG, Gunter MJ, Jenab M, Liao LM, Milne RL, Robien K, Sandler DP, Schairer C, Sesso HD, Shu XO, Weiderpass E, Wolk A, Xiang YB, Zeleniuch-Jacquotte A, Zheng W, Gapstur SM. Body Size Indicators and Risk of Gallbladder Cancer: Pooled Analysis of Individual-Level Data from 19 Prospective Cohort Studies. Cancer Epidemiol Biomarkers Prev 2017; 26:597-606. [PMID: 28314823 PMCID: PMC5380577 DOI: 10.1158/1055-9965.epi-16-0796] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 11/18/2016] [Accepted: 11/23/2016] [Indexed: 01/15/2023] Open
Abstract
Background: There are few established risk factors for gallbladder cancer beyond gallstones. Recent studies suggest a higher risk with high body mass index (BMI), an indicator of general heaviness, but evidence from other body size measures is lacking.Methods: Associations of adult BMI, young adult BMI, height, adult weight gain, waist circumference (WC), waist-height ratio (WHtR), hip circumference (HC), and waist-hip ratio (WHR) with gallbladder cancer risk were evaluated. Individual-level data from 1,878,801 participants in 19 prospective cohort studies (14 studies had circumference measures) were harmonized and included in this analysis. Multivariable Cox proportional hazards regression estimated hazard ratios (HR) and 95% confidence intervals (CI).Results: After enrollment, 567 gallbladder cancer cases were identified during 20.1 million person-years of observation, including 361 cases with WC measures. Higher adult BMI (per 5 kg/m2, HR: 1.24; 95% CI, 1.13-1.35), young adult BMI (per 5 kg/m2, HR: 1.12; 95% CI, 1.00-1.26), adult weight gain (per 5 kg, HR: 1.07; 95% CI, 1.02-1.12), height (per 5 cm, HR: 1.10; 95% CI, 1.03-1.17), WC (per 5 cm, HR: 1.09; 95% CI, 1.02-1.17), WHtR (per 0.1 unit, HR: 1.24; 95% CI, 1.00-1.54), and HC (per 5 cm, HR: 1.13; 95% CI, 1.04-1.22), but not WHR (per 0.1 unit, HR: 1.03; 95% CI, 0.87-1.22), were associated with higher risks of gallbladder cancer, and results did not differ meaningfully by sex or other demographic/lifestyle factors.Conclusions: These findings indicate that measures of overall and central excess body weight are associated with higher gallbladder cancer risks.Impact: Excess body weight is an important, and potentially preventable, gallbladder cancer risk factor. Cancer Epidemiol Biomarkers Prev; 26(4); 597-606. ©2017 AACR.
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Affiliation(s)
- Peter T Campbell
- Epidemiology Research Program, American Cancer Society, Atlanta, Georgia.
| | - Christina C Newton
- Epidemiology Research Program, American Cancer Society, Atlanta, Georgia
| | - Cari M Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Alpa V Patel
- Epidemiology Research Program, American Cancer Society, Atlanta, Georgia
| | - Patricia Hartge
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Jill Koshiol
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Katherine A McGlynn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Hans-Olov Adami
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Medical Epidemiology and Biostatistics, Karolinska Insitutet, Stockholm, Sweden
| | | | - Laura E Beane Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Leslie Bernstein
- Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, California
| | - Julie E Buring
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Divisions of Preventive Medicine and Aging, Brigham and Women's Hospital, Boston, Massachusetts
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China
| | - Graham G Giles
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia; and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Marc J Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Mazda Jenab
- Section of Nutrition and Metabolism, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Linda M Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Roger L Milne
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia; and Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
| | - Kim Robien
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health/Department of Health and Human Services, Research Triangle Park, North Carolina
| | - Catherine Schairer
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Howard D Sesso
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Divisions of Preventive Medicine and Aging, Brigham and Women's Hospital, Boston, Massachusetts
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics, Karolinska Insitutet, Stockholm, Sweden
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Genetic Epidemiology Group, Samfundet Folkhälsan, Research Center Helsinki, Finland
| | - Alicja Wolk
- Department of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Yong-Bing Xiang
- Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, P.R. China
| | | | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Susan M Gapstur
- Epidemiology Research Program, American Cancer Society, Atlanta, Georgia
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Peña Dávila FE, Sánchez Renteria FA, Fernandez Mogollon J, Rodríguez Rodríguez MR. [The frequency and clinical profile of gallbladder cancer in patients undergoing cholecystectomy in 3 reference hospitals in Chiclayo between 2011-2015]. Rev Gastroenterol Peru 2017; 37:142-145. [PMID: 28731994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To describe the frequency and clinical profile of gallbladder cancer in patients undergoing cholecystectomy in 3 reference hospitals in Chiclayo between 2011-2015. MATERIALS AND METHODS A retrospective cross-sectional study. The study is divided into 2 phases, the first was to count the total number of reports of gallbladder pathology and select positive cases for cancer; the second phase was to collect data from the medical records of patients positive for cancer. RESULTS From 5720 pathology reports gallbladder, 58 (1.01%) were positive for vesicular neoplasia. 42 cases (72.4%) were women and only 16 (27.6%) were men. The most common symptom was abdominal pain in 41 cases (70.7%). 18 patients (31%) reported other symptoms, the hyporexia was the most frequent with 8 cases (13.8%). 41 cases (70.7%) had gallstone. The predominant type of cancer was adenocarcinoma in 48 cases (82.8%) followed by mucinous carcinoma in 3 cases (5.2%). CONCLUSIONS In the department of Lambayeque frequency of gallbladder cancer was 1.01% with predominance in females and sixth decade of life, being Adenocarcinoma, the most common type. Likewise, patients had more frequent abdominal pain and jaundice.
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Nelson SM, Gao YT, Nogueira LM, Shen MC, Wang B, Rashid A, Hsing AW, Koshiol J. Diet and biliary tract cancer risk in Shanghai, China. PLoS One 2017; 12:e0173935. [PMID: 28288186 PMCID: PMC5348031 DOI: 10.1371/journal.pone.0173935] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 02/28/2017] [Indexed: 12/15/2022] Open
Abstract
Trends in biliary tract cancer incidence rates have increased in Shanghai, China. These trends have coincided with economic and developmental growth, as well as a shift in dietary patterns to a more Westernized diet. To examine the effect of dietary changes on incident disease, we evaluated associations between diet and biliary tract cancers amongst men and women from a population-based case-control study in Shanghai, China. Biliary tract cancer cases were recruited from 42 collaborating hospitals in urban Shanghai, and population-based controls were randomly selected from the Shanghai Household Registry. Food frequency questionnaire data were available for 225 gallbladder, 190 extrahepatic bile duct, and 68 ampulla of Vater cancer cases. A total of 39 food groups were created and examined for associations with biliary tract cancer. Interestingly, only four food groups demonstrated a suggested association with gallbladder, extrahepatic bile duct, or ampulla of Vater cancers. The allium food group, consisting of onions, garlic, and shallots showed an inverse association with gallbladder cancer (OR: 0.81, 95% CI: 0.68-0.97). Similar trends were seen in the food group containing seaweed and kelp (OR: 0.79, 95% CI: 0.67-0.96). In contrast, both preserved vegetables and salted meats food groups showed positive associations with gallbladder cancer (OR:1.27, 95% CI: 1.06-1.52; OR: 1.18, 95% CI: 1.02-1.37, respectively). Each of these four food groups showed similar trends for extrahepatic bile duct and ampulla of Vater cancers. The results of our analysis suggest intake of foods with greater anti-inflammatory properties may play a role in decreasing the risk of biliary tract cancers. Future studies should be done to better understand effects of cultural changes on diet, and to further examine the impact diet and inflammation have on biliary tract cancer incidence.
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Affiliation(s)
- Shakira M Nelson
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Rockville, Maryland, United States of America
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, United States of America
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China
| | - Leticia M Nogueira
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Rockville, Maryland, United States of America
- Texas Cancer Registry, Cancer Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, Texas, United States of America
| | - Ming-Chang Shen
- Department of Pathology, Shanghai Cancer Center, Fudan University, Shanghai, China
| | - Bingsheng Wang
- Department of General Surgery, Zhongshan Hospital, School of Medicine, Fudan University, Shanghai, China
| | - Asif Rashid
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texass, United States of America
| | - Ann W Hsing
- Stanford Cancer Institute, Palo Alto, California, United States of America
- Stanford Prevention Research Center, Stanford School of Medicine, Palo Alto, California, United States of America
| | - Jill Koshiol
- Infectious and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, United States of America
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Abstract
Despite the aggressive nature and poor prognosis of gall-bladder cancer there is a group of patients who can achieve significant benefits from a radical surgical treatment. The possibility of obtaining long-term survival, even in case of patients with locally advanced cancer and metastases to regional lymph nodes, prompts to verify nihilistic approach to the treatment of this disease. Obviously such therapy can and should be performed only in centers specializing in hepatobiliary surgery. Due to the high recurrence rate, most of which are systemic, the hope of improving treatment outcomes should be sought in the use of combination therapy, based on a new chemotherapy and chemoradiotherapy regimens with the addition of targeted therapy. Unfortunately, the current application of these methods did not bring the expected benefits.
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