Neuroendocrine Neoplasms of the Gallbladder: Early Detection and Surgery Is Key to Improved Outcome

Authors

Shekhar Gogna, Department of Surgery, Westchester Medical Center/New York Medical College, Valhalla, NY, USA.
David Samson, Department of Surgery, Westchester Medical Center/New York Medical College, Valhalla, NY, USA.
Mahir Gachabayov, Department of Surgery, Westchester Medical Center/New York Medical College, Valhalla, NY, USA.
Aram Rojas, Department of Surgery, Westchester Medical Center/New York Medical College, Valhalla, NY, USA.
Daniel Moritz Felsenreich, Division of General Surgery, Department of General Surgery, Vienna Medical University, Vienna, Austria.
Donna Koo, Department of Surgery, New York Medical College, Valhalla, NY, USA.
Katie Gu, Section of Surgical Oncology, Department of Surgery, Nuvance Health/University of Vermont, Norwalk, CT, USA.
Luis Quintero, Department of Surgery, New York Medical College, Valhalla, NY, USA.
Kendall Ryan Miller, Section of Surgical Oncology, Department of Surgery, Nuvance Health/University of Vermont, Norwalk, CT, USA.
Asad Azim, Department of Surgery, Westchester Medical Center/New York Medical College, Valhalla, NY, USA.Follow
Xiang Da Eric Dong, Section of Surgical Oncology, Department of Surgery, Nuvance Health/University of Vermont, Norwalk, CT, USA. xddong@hotmail.com.

Author Type(s)

Faculty, Resident/Fellow

DOI

10.1007/s00423-021-02256-z

Journal Title

Langenbeck's Archives of Surgery

First Page

197

Last Page

206

Document Type

Article

Publication Date

2-1-2022

Department

Surgery

Abstract

PURPOSE: Neuroendocrine neoplasms (NENs) of the gallbladder are very rare. As a result, the classification of pathologic specimens from gallbladder NENs, currently classified as gallbladder neuroendocrine tumors (GB-NETs) and carcinomas (GB-NECs), is inconsistent and makes nomenclature, classification, and management difficult. Our study aims to evaluate the epidemiological trend, tumor biology, and outcomes of GB-NET and GB-NEC over the last 5 decades. METHODS: This is a retrospective analysis of the SEER database from 1973 to 2016. The epidemiological trend was analyzed using the age-adjusted Joinpoint regression analysis. Survival was assessed with Kaplan-Meier analysis and Cox regression was used to assess predictors of poor survival. RESULTS: A total of 482 patients with GB-NEN were identified. Mean age at diagnosis was 65.2 ± 14.3 years. Females outnumbered males (65.6% vs. 34.4%). The Joinpoint nationwide trend analysis showed a 7% increase per year from 1973 to 2016. The mean survival time after diagnosis of GB-NEN was 37.11 ± 55.3 months. The most common pattern of nodal distribution was N0 (50.2%) followed by N1 (30.9%) and N2 (19.2%). Advanced tumor spread (into the liver, regional, and distant metastasis) was seen in 60.3% of patients. Patients who underwent surgery had a significant survival advantage (111.0 ± 8.3 vs. 8.3 ± 1.2 months, p < 0.01). Cox regression analysis showed advanced age (p < 0.01), tumor stage (P < 0.01), tumor extension (p < 0.01), and histopathologic grade (p < 0.01) were associated with higher mortality. CONCLUSION: Gallbladder NENs are a rare histopathological variant of gallbladder cancer that is showing a rising incidence in the USA. In addition to tumor staging, surgical resection significantly impacts patient survival, when patients are able to undergo surgery irrespective of tumor staging. Advanced age, tumor extension, and histopathological grade of the tumor were associated with higher mortality.

Recommended Citation

Gogna, S., Samson, D., Gachabayov, M., Rojas, A., Felsenreich, D. M., Koo, D., Gu, K., Quintero, L., Miller, K. R., Azim, A., & Da Eric Dong, X. (2022). Neuroendocrine Neoplasms of the Gallbladder: Early Detection and Surgery Is Key to Improved Outcome. Langenbeck's Archives of Surgery, 407 (1), 197-206. https://doi.org/10.1007/s00423-021-02256-z