Abstract
Background: Gallbladder cancer (GBC) is an aggressive, uncommon malignancy, with variation in operative approaches adopted across centres and few large-scale studies to guide practice. We aimed to identify the extent of heterogeneity in GBC internationally to better inform the need for future multicentre studies. Methods: A 34-question online survey was disseminated to members of the European-African Hepatopancreatobiliary Association (EAHPBA), American Hepatopancreatobiliary Association (AHPBA) and Asia–Pacific Hepatopancreatobiliary Association (A-PHPBA) regarding practices around diagnostic workup, operative approach, utilization of neoadjuvant and adjuvant therapies and surveillance strategies. Results: Two hundred and three surgeons responded from 51 countries. High liver resection volume units (>50 resections/year) organised HPB multidisciplinary team discussion of GBCs more commonly than those with low volumes (p < 0.0001). Management practices exhibited areas of heterogeneity, particularly around operative extent. Contrary to consensus guidelines, anatomical liver resections were favoured over non-anatomical resections for T3 tumours and above, lymphadenectomy extent was lower than recommended, and a minority of respondents still routinely excised the common bile duct or port sites. Conclusion: Our findings suggest some similarities in the management of GBC internationally, but also specific areas of practice which differed from published guidelines. Transcontinental collaborative studies on GBC are necessary to establish evidence-based practice to minimise variation and optimise outcomes.
| Original language | English |
|---|---|
| Pages (from-to) | 2006-2012 |
| Number of pages | 7 |
| Journal | HPB |
| Volume | 24 |
| Issue number | 11 |
| Early online date | 2022 |
| DOIs | |
| Publication status | Published - Nov 2022 |
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In: HPB, Vol. 24, No. 11, 11.2022, p. 2006-2012.
Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Heterogeneity of management practices surrounding operable gallbladder cancer – results of the OMEGA-S international HPB surgical survey
AU - Balakrishnan, Anita
AU - Jah, Asif
AU - Lesurtel, Mickael
AU - Andersson, Bodil
AU - Gibbs, Paul
AU - Harper, Simon J. F.
AU - Huguet, Emmanuel L.
AU - Kosmoliaptsis, Vasilis
AU - Liau, Siong S.
AU - Praseedom, Raaj K.
AU - Ramia, Jose M.
AU - Branes, Alejandro
AU - Lendoire, Javier
AU - Maithel, Shishir
AU - Serrablo, Alejandro
AU - The EAHPBA Scientific and Research Committee and the OMEGA study collaborators
AU - Abe, T.
AU - Achalandabaso, M.
AU - Adham, M.
AU - Ahmet, A.
AU - Al-Sarireh, B.
AU - Albiol Quer, M.
AU - Alconchel, F.
AU - Alejandro, R. A.
AU - Alsammani, M.
AU - Alseidi, A.
AU - Anand, A.
AU - Anselmo, A.
AU - Antonakis, P.
AU - Arabadzhieva, E.
AU - de Aretxabala, X.
AU - Aroori, S.
AU - Ashley, S.
AU - Ausania, F.
AU - Banerjee, A.
AU - Barabino, M.
AU - Bartlett, A.
AU - Bartsch, F.
AU - Belli, A.
AU - Beristain-Hernandez, J.
AU - Berrevoet, F.
AU - Bhatti, A. B. H.
AU - Bhojwani, R.
AU - Bjornsson, B.
AU - Blaz, T.
AU - Byrne, M.
AU - Calvo, M. P.
AU - Castellanos, J.
AU - Castro, M. J.
AU - Daams, F.
AU - Erdmann, J.
N1 - Funding Information: OMEGA-S Collaborative Study Group:, Abe T, Achalandabaso M, Adham M, Ahmet A, Al-Sarireh B, Albiol Quer M, Alconchel F, Alsammani M, Alseidi A, Anand A, Anselmo A, Antonakis P, Arabadzhieva E, de Aretxabala X, Aroori S, Ashley S, Ausania F, Banerjee A, Barabino M, Bartlett A, Bartsch F, Belli A, Beristain-Hernandez J, Berrevoet F, Bhatti ABH, Bhojwani R, Bjornsson B, Blaz T, Byrne M, Calvo MP, Castellanos J, Castro MJ, Cavallucci D, Chang D, Christodoulis G, Ciacio O, Clavien PA, Coker A, Conde-Rodriguez M, D'Amico FE, D'Hondt M, Daams F, Dasari BVM, De Bellis M, de Meijer VE, Dede K, Deiro G, Delgado FJB, Desai G, Di Gioia A, Di Martino M, Dixon M, Dorovinis P, Dumitrascu T, Ebata T, Eilard MS, Erdmann J, Erkan M, Famularo S, Felli E, Fergadi M, Fernandez GB, Fox A, Galodha S, Galun D, Ganandha S, Garcia RJR, Gemenetzis G, Giannone F, Gil L, Giorgakis E, Giovinazzo F, Giuffrida M, Giuliani T, Giuliante F, Gkekas I, Goel M, Goh BK, Gomes A, Gruenberger T, Guevara O, Gulla A, Gupta A, Gupta R, Hakeem AR, Hamid HKS, Heinrich S, Helton S, Hernandez-Alejandro R, Heumann A, Higuchi R, Hughes D, Inarejos BC, Ivanecz A, Iwao Y, Iype S, Jaen I, Jie MJ, Jones R, Kacirek K, Kalayarasan R, Kaldarov A, Kaman L, Kanhere H, Kapoor VK, Karanicolas P, Karayiannakis A, Kausar A, Khan ZA, Kim D-S, Klose J, Knowles B, Koh PS, Kolodziejczyk P, Komorowski AL, Koong JK, Kozyrin I, Krishna A, Kron P, Kumar N, van Laarhoven S, Lakhey PJ, Lanari J, Laurenzi A, Leow VM, Limbu Y, Liu Y-B, Lob S, Lolis E, Lopez-Lopez V, Lozano RC, Lundgren L, Machairas N, Magouliotis D, Mahamid A, Malde D, Malek A, Malik H, Malleo G, Marino MV, Mayo SC, Mazzola M, Memeo R, Menon K, Menzulin R, Mohan R, Morgul H, Moris D, Mulita F, Muttillo EM, Nahm C, Nandasena M, Nashidengo PR, Nickkholgh A, Nikov A, Noel C, O'Reilly D, O'Rourke T, Ohtsuka M, Omoshoro-Jones JAO, Pandanaboyana S, Pararas N, Patel R, Patkar S, Peng JS, Perfecto A, Perinel J, Perivoliotis K, Perra T, Phan MT, Piccolo G, Porcu A, Primavesi F, Primrose J, Pueyo-Periz E, Radenkovic D, Rammohan A, Rowcroft A, Sakata J, Saladino E, Schena CA, Scholer A, Schwarz C, Serrano P, Silva M, Soreide K, Sparrelid E, Stattner S, Sturesson C, Sugiura T, Sumo M, Sutcliffe R, Teh C, Teo JY, Tepetes K, Thapa PB, Thepbunchonchai A, Torres JBP, Torres OJM, Torzili G, Tovikkai C, Troncoso A, Tsoulfas G, Tuzuher A, Tzimas G, Umar GI, Urbani L, Vanagas T, Varga, Velayutham V, Vigano L, Wakai T, Yang Z, Yip V, Zacharoulis D, Zakharov EA, Zimmitti G. The authors would also like to acknowledge the invaluable assistance of Carrie Hooper in the dissemination of the survey. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Publisher Copyright: © 2022 International Hepato-Pancreato-Biliary Association Inc.
PY - 2022/11
Y1 - 2022/11
N2 - Background: Gallbladder cancer (GBC) is an aggressive, uncommon malignancy, with variation in operative approaches adopted across centres and few large-scale studies to guide practice. We aimed to identify the extent of heterogeneity in GBC internationally to better inform the need for future multicentre studies. Methods: A 34-question online survey was disseminated to members of the European-African Hepatopancreatobiliary Association (EAHPBA), American Hepatopancreatobiliary Association (AHPBA) and Asia–Pacific Hepatopancreatobiliary Association (A-PHPBA) regarding practices around diagnostic workup, operative approach, utilization of neoadjuvant and adjuvant therapies and surveillance strategies. Results: Two hundred and three surgeons responded from 51 countries. High liver resection volume units (>50 resections/year) organised HPB multidisciplinary team discussion of GBCs more commonly than those with low volumes (p < 0.0001). Management practices exhibited areas of heterogeneity, particularly around operative extent. Contrary to consensus guidelines, anatomical liver resections were favoured over non-anatomical resections for T3 tumours and above, lymphadenectomy extent was lower than recommended, and a minority of respondents still routinely excised the common bile duct or port sites. Conclusion: Our findings suggest some similarities in the management of GBC internationally, but also specific areas of practice which differed from published guidelines. Transcontinental collaborative studies on GBC are necessary to establish evidence-based practice to minimise variation and optimise outcomes.
AB - Background: Gallbladder cancer (GBC) is an aggressive, uncommon malignancy, with variation in operative approaches adopted across centres and few large-scale studies to guide practice. We aimed to identify the extent of heterogeneity in GBC internationally to better inform the need for future multicentre studies. Methods: A 34-question online survey was disseminated to members of the European-African Hepatopancreatobiliary Association (EAHPBA), American Hepatopancreatobiliary Association (AHPBA) and Asia–Pacific Hepatopancreatobiliary Association (A-PHPBA) regarding practices around diagnostic workup, operative approach, utilization of neoadjuvant and adjuvant therapies and surveillance strategies. Results: Two hundred and three surgeons responded from 51 countries. High liver resection volume units (>50 resections/year) organised HPB multidisciplinary team discussion of GBCs more commonly than those with low volumes (p < 0.0001). Management practices exhibited areas of heterogeneity, particularly around operative extent. Contrary to consensus guidelines, anatomical liver resections were favoured over non-anatomical resections for T3 tumours and above, lymphadenectomy extent was lower than recommended, and a minority of respondents still routinely excised the common bile duct or port sites. Conclusion: Our findings suggest some similarities in the management of GBC internationally, but also specific areas of practice which differed from published guidelines. Transcontinental collaborative studies on GBC are necessary to establish evidence-based practice to minimise variation and optimise outcomes.
UR - http://www.scopus.com/inward/record.url?scp=85137609551&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.hpb.2022.06.014
DO - https://doi.org/10.1016/j.hpb.2022.06.014
M3 - Article
C2 - 35922277
SN - 1365-182X
VL - 24
SP - 2006
EP - 2012
JO - HPB: The official journal of the International Hepato Pancreato Biliary Association
JF - HPB: The official journal of the International Hepato Pancreato Biliary Association
IS - 11
ER -