Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2024; 16(1): 95-102
Published online Jan 27, 2024. doi: 10.4240/wjgs.v16.i1.95
Post-operative morbidity after neoadjuvant chemotherapy and resection for gallbladder cancer: A national surgical quality improvement program analysis
Minha Kim, Stephanie Stroever, Krist Aploks, Alexander Ostapenko, Xiang Da Dong, Ramanathan Seshadri
Minha Kim, Krist Aploks, Alexander Ostapenko, Department of General Surgery, Danbury Hospital, Danbury, CT 06810, United States
Stephanie Stroever, Department of Research and Innovation, Nuvance Health, Danbury, CT 06810, United States
Xiang Da Dong, Ramanathan Seshadri, Division of Surgical Oncology/Hepato-Pancreato-Biliary Surgery, Danbury Hospital, Danbury, CT 06810, United States
Author contributions: Kim, M, Aploks K, Ostapenko A, Dong X, and Seshadri R contributed to the conceptualization of the project; Kim M, Stroever S, Aploks K, Ostapenko A, Dong X, and Seshadri R contributed to the methodology and validation of the data; Stroever S conducted the formal statistical analyses; Kim, M, Aploks K, Ostapenko A prepared the original manuscript; Kim, M, Aploks K, Ostapenko A, Dong X, and Seshadri R contributed to the final draft revision and edition; Dong X, and Seshadri R supervised the project.
Institutional review board statement: Ethical review and approval was not required for this study since the data used was de-identified and obtained from a participant use file.
Informed consent statement: This study is a retrospective review that utilized only de-identified patient data from the American College of Surgeons National Surgical Quality Improvement Program.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: Data was obtained with the permission from the American College of Surgeons NSQIP database. NSQIP data can be obtained at https://www.facs.org/quality-programs/data-and-registries/acs-nsqip/.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ramanathan Seshadri, MD, Surgeon, Division of Surgical Oncology/Hepato-Pancreato-Biliary Surgery, Danbury Hospital, 95 Locus Avenue, Danbury, CT 06810, United States. ramanathan.seshadri@nuvancehealth.org
Received: September 23, 2023
Peer-review started: September 23, 2023
First decision: November 9, 2023
Revised: November 27, 2023
Accepted: December 18, 2023
Article in press: December 18, 2023
Published online: January 27, 2024
ARTICLE HIGHLIGHTS
Research background

Gallbladder cancer is the most common malignancy of the biliary tract. There are no consensus guidelines in regards to the use of neoadjuvant chemotherapy (NACT) for gallbladder cancer. Until a standardized regimen and guidelines are implemented, surgeons need to be aware of the potential effects of NACT on post-operative outcomes.

Research motivation

NACT is recommended based on clinical and pathological findings. Physicians need to carefully tailor the management of gallbladder cancer to the individual patient. By being aware of the benefits and risks of NACT both pre-operative and post-operatively, physicians can make informed decisions regarding its use in gallbladder cancer.

Research objectives

The objective of the study was to investigate the 30-day post-operative morbidities associated with NACT in gallbladder cancer.

Research methods

We performed a retrospective analysis using the National Surgery Quality Improvement Program database between 2015 and 2019. Patients with gallbladder cancer were identified and divided the patients into two cohorts based on their NACT status.

Research results

Compared to the upfront surgery group, patients who underwent chemotherapy and surgery for gallbladder cancer did not experience worse outcome. There were no statistically significant post-operative morbidities.

Research conclusions

While there were no differences in the 30-day post-operative morbidities between the two cohorts, the benefits and risks of NACT should be carefully considered for patients, taking into account the potential side effects of chemotherapy.

Research perspectives

Further research on the effects of NACT for gallbladder cancer needs to be conducted. When more clinical data is available, the post-operative morbidities associated with NACT can be further evaluated.