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 language | English |
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Pages (from-to) | 1005-1012 |
Number of pages | 8 |
Journal | Hepato-Gastroenterology |
Volume | 57 |
Issue number | 102-103 |
State | Published - Sep 2010 |
Keywords
- Advanced gallbladder carcinoma
- Liver resection
- Lymphadenectomy
- Resectability
- Survival