Surgical resection for advanced gallbladder carcinoma. The Mount Sinai experience

Manousos M. Konstadoulakis, Sasan Roayaie, Ilias P. Gomatos, Daniel Labow, Maria Isabell Fiel, Charles M. Miller, Myron E. Schwartz

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background/Aims: Advanced gallbladder cancer (GC) carries dismal prognosis, due to its extent at diagnosis and the low RO resection performance rate. Methodology: Thirty-two GC patients referred to our Department with an intention to treat between 1993 and 2005. All patients had advanced T stage (≥T3). Pathological findings, surgical procedures and survival data were analyzed. Results: Seventeen radical procedures (16 hepatectomies and 1 cholecystectomy with common bile duct resection), 4 palliative procedures (12.5%) and 11 surgical explorations (34.4%) were performed (53.1%, resectability rate). Hepatectomies were performed with 0% mortality, 11.8% morbidity and 94.1% resectability rate. The respective 1-, 3- and 5- year survival rates were 71.4%, 28.6% and 14.3%. Radical lymph node dissection (p=0.03), absence of perineural tumor invasion (p=0.03) and patients' age <70 years (p<0.01) were non-independently associated with favorable prognosis in the hepatectomy-treated group of GC patients. Conclusions: GC patients with stage ≥ILA should be treated with hepatectomy combined with radical lymphadenectomy in order to achieve better staging and disease control. Incorporating the caudate lobe, more than 4 liver segments, or part of the extrahepatic biliary tree in the resection specimen in selected patients, might help eliminate perineural metastatic spread and achieve improved overall survival.

Original languageEnglish
Pages (from-to)1005-1012
Number of pages8
JournalHepato-Gastroenterology
Volume57
Issue number102-103
StatePublished - Sep 2010

Keywords

  • Advanced gallbladder carcinoma
  • Liver resection
  • Lymphadenectomy
  • Resectability
  • Survival

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