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Preoperative CT findings for prediction of resectability in patients with gallbladder cancer.

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Title: Preoperative CT findings for prediction of resectability in patients with gallbladder cancer.
Authors: Choi, Seo-Youn1 (AUTHOR), Kim, Jung Hoon2,3,4 (AUTHOR) jhkim2008@gmail.com, Park, Hyun Jeong5 (AUTHOR), Han, Joon Koo2,3,4 (AUTHOR)
Source: European Radiology. Dec2019, Vol. 29 Issue 12, p6458-6468. 11p. 4 Diagrams, 3 Charts, 2 Graphs.
Subjects: Gallbladder cancer, Tumor classification, Hepatic artery, Bile ducts, Multidetector computed tomography, Portal vein
Abstract: Objectives: To predict residual tumor (R) classification in patients with a surgery for gallbladder (GB) cancer, using preoperative CT.Methods: One hundred seventy-three patients with GB cancer who underwent CT and subsequent surgery were included. Two radiologists assessed CT findings, including tumor morphology, location, T stage, adjacent organ invasion, hepatic artery (HA) invasion, portal vein invasion, lymph node metastasis, metastasis, resectability, gallstone, and combined cholecystitis. The R classification was categorized as no residual tumor (R0) and residual tumor (R1 or R2). We analyzed the correlation between CT findings and R classification. We also followed up the patients as long as five years and analyzed the relationship between the R classification and the overall survival (OS).Results: There were 134 patients with R0 and 39 patients with R1/R2. On multivariable analysis, liver invasion (Exp(B) = 3.19, p = 0.010), bile duct invasion (Exp(B) = 3.69, p = 0.031), and HA invasion (Exp(B) = 3.74, p = 0.039) were independent, significant predictors for residual tumor. When two of these three criteria were combined, the accuracy for predicting a positive resection margin was 83.38% with a specificity of 93.28%. The OS and the median patient survival time differed significantly according to the resection margin, i.e., 56.0% and 134.4 months in the R0 resection and 5.1% and 10.8 months in the R1/R2 resection group (p < 0.001).Conclusions: Preoperative CT findings could aid in planning surgery and determining the resectability using the high-risk findings of residual tumor, including liver invasion, bile duct invasion, and HA invasion.Key Points: • Liver invasion, bile duct invasion, and HA invasion were significant preoperative CT predictors for residual tumor in GB cancer. • HA invasion showed the highest OR on multivariate analysis and the highest predictor point on a nomogram for predicting a positive resection margin. • Association of two factors can predict positive resection margin with an accuracy of 83.38% and a specificity of 93.28%. [ABSTRACT FROM AUTHOR]
Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Preoperative CT findings for prediction of resectability in patients with gallbladder cancer.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Choi%2C+Seo-Youn%22&quot;&gt;Choi, Seo-Youn&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Kim%2C+Jung+Hoon%22&quot;&gt;Kim, Jung Hoon&lt;/searchLink&gt;&lt;relatesTo&gt;2,3,4&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; jhkim2008@gmail.com&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Park%2C+Hyun+Jeong%22&quot;&gt;Park, Hyun Jeong&lt;/searchLink&gt;&lt;relatesTo&gt;5&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Han%2C+Joon+Koo%22&quot;&gt;Han, Joon Koo&lt;/searchLink&gt;&lt;relatesTo&gt;2,3,4&lt;/relatesTo&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22European+Radiology%22&quot;&gt;European Radiology&lt;/searchLink&gt;. Dec2019, Vol. 29 Issue 12, p6458-6468. 11p. 4 Diagrams, 3 Charts, 2 Graphs.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Gallbladder+cancer%22&quot;&gt;Gallbladder cancer&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Tumor+classification%22&quot;&gt;Tumor classification&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Hepatic+artery%22&quot;&gt;Hepatic artery&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Bile+ducts%22&quot;&gt;Bile ducts&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Multidetector+computed+tomography%22&quot;&gt;Multidetector computed tomography&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Portal+vein%22&quot;&gt;Portal vein&lt;/searchLink&gt;
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  Label: Abstract
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  Data: &lt;bold&gt;Objectives: &lt;/bold&gt;To predict residual tumor (R) classification in patients with a surgery for gallbladder (GB) cancer, using preoperative CT.&lt;bold&gt;Methods: &lt;/bold&gt;One hundred seventy-three patients with GB cancer who underwent CT and subsequent surgery were included. Two radiologists assessed CT findings, including tumor morphology, location, T stage, adjacent organ invasion, hepatic artery (HA) invasion, portal vein invasion, lymph node metastasis, metastasis, resectability, gallstone, and combined cholecystitis. The R classification was categorized as no residual tumor (R0) and residual tumor (R1 or R2). We analyzed the correlation between CT findings and R classification. We also followed up the patients as long as five years and analyzed the relationship between the R classification and the overall survival (OS).&lt;bold&gt;Results: &lt;/bold&gt;There were 134 patients with R0 and 39 patients with R1/R2. On multivariable analysis, liver invasion (Exp(B) = 3.19, p = 0.010), bile duct invasion (Exp(B) = 3.69, p = 0.031), and HA invasion (Exp(B) = 3.74, p = 0.039) were independent, significant predictors for residual tumor. When two of these three criteria were combined, the accuracy for predicting a positive resection margin was 83.38% with a specificity of 93.28%. The OS and the median patient survival time differed significantly according to the resection margin, i.e., 56.0% and 134.4&#160;months in the R0 resection and 5.1% and 10.8&#160;months in the R1/R2 resection group (p &lt; 0.001).&lt;bold&gt;Conclusions: &lt;/bold&gt;Preoperative CT findings could aid in planning surgery and determining the resectability using the high-risk findings of residual tumor, including liver invasion, bile duct invasion, and HA invasion.&lt;bold&gt;Key Points: &lt;/bold&gt;• Liver invasion, bile duct invasion, and HA invasion were significant preoperative CT predictors for residual tumor in GB cancer. • HA invasion showed the highest OR on multivariate analysis and the highest predictor point on a nomogram for predicting a positive resection margin. • Association of two factors can predict positive resection margin with an accuracy of 83.38% and a specificity of 93.28%. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1007/s00330-019-06323-4
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      – Code: eng
        Text: English
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    Subjects:
      – SubjectFull: Gallbladder cancer
        Type: general
      – SubjectFull: Tumor classification
        Type: general
      – SubjectFull: Hepatic artery
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      – SubjectFull: Bile ducts
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      – SubjectFull: Multidetector computed tomography
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      – TitleFull: Preoperative CT findings for prediction of resectability in patients with gallbladder cancer.
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              Text: Dec2019
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              Y: 2019
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