Erschienen in:
15.08.2017 | Letter to the Editor
Predicting Resectability in Gallbladder Cancer: the Tata Memorial Hospital Staging System
verfasst von:
Savio G. Barreto, Parul J. Shukla
Erschienen in:
Journal of Gastrointestinal Surgery
|
Ausgabe 11/2017
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Excerpt
We read with interest the article by Tran and colleagues
1 revisiting the long-held concern of offering a trial of resection in gallbladder cancer patients with jaundice. One of the concerns in gallbladder cancer has been the increased risk of mortality following exploratory laparotomies that did not progress to a meaningful resection.
2 Hawkins and colleagues had reiterated this concern highlighting jaundice as an important factor in recognising patients with advanced disease.
3 In the absence of any prior system that would enable a selection of patients who were most likely to undergo a meaningful resection, we had proposed the Tata Memorial Hospital Staging System (TMHSS).
4 This simple system that combined easily available clinical, biochemical and radiological parameters to arrive at a score that would help achieve just that! The study by Tran and colleagues, a decade on, validates the TMHSS given that the patients with a CA 19-9 level less than 50 would at worst (with a score of 0 from jaundice and 4 from imaging) reach a total of 6 by the TMHSS making them suitable candidates to be considered for an exploration, on the balance of the evidence. …
