J Korean Surg Soc.  2010 Jun;78(6):398-404. 10.4174/jkss.2010.78.6.398.

Radical Reresection for T2 Gallbladder Cancer Patients Diagnosed following Laparoscopic Cholecystectomy

• Lee BS
• Kim DH
• Chang YS
• Kang JH
• Lee TS
• Han JG

• KMID: 2211971
• DOI: http://doi.org/10.4174/jkss.2010.78.6.398

Abstract

PURPOSE
Despite advances in imaging techniques, laparoscopic cholecystectomy (LC) gives many advantages to some patients with suspected gallbladder cancer. The aim of this study was to investigate clinicopathological features and to analyze the risk factors of recurrence after radical reresection for T2 gallbladder cancer patients diagnosed following LC.
METHODS
From January 2002 to December 2009, the data of 21 consecutive patients for radical reresection for T2 gallbladder cancer were reviewed, retrospectively. The significance of the variables for recurrence was examined by the Kaplan-Meier method and log-rank test followed by multivariate analyses using Cox's proportional hazard model.
RESULTS
Of the 21 patients studied, 11 were men and 10 were women. Lymph node metastasis was present in 7 patients (33.4%). The 5-year survival rate and disease-free survival rate in those patients were 75.3% and 67.9%, respectively. In the univariate analysis, the male gender (P=0.0047), poorly differentiated tumor (P=0.0169), presence of lymph node metastasis (P=0.0012), presence of lymphovascular invasion (P=0.0259) and presence of perineural invasion (P=0.0096) were significant factors related to recurrence after radical reresection. In the multivariate analysis, the presence of lymph node metastasis was an independently significant factor (5-year disease free survival rate, 20.9% vs. 83.8% in the absence of lymph node metastasis; P=0.015).
CONCLUSION
For patients with T2 gallbladder carcinoma diagnosed following LC, radical reresection is highly recommended and the presence of lymph node metastasis is an unfavorable prognostic factor that calls for additional treatment after radical surgery.

Keyword

Laparoscopic cholecystectomy; Gallbladder carcinoma; Prognostic factor; Radical reresection

MeSH Terms

Cholecystectomy, Laparoscopic
Disease-Free Survival
Female
Gallbladder
Gallbladder Neoplasms
Humans
Lymph Nodes
Male
Multivariate Analysis
Neoplasm Metastasis
Proportional Hazards Models
Recurrence
Retrospective Studies
Risk Factors
Survival Rate

Figure

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  Fig. 1 (A) Overall survival rates in patients with T2 gallbladder carcinoma undergone radical reresection following laparoscopic cholecystectomy. (B) Disease free survival rates in patients with T2 gallbladder carcinoma undergone radical reresection following laparoscopic cholecystectomy.

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  Fig. 2 Disease free survival rates in patients with T2 gallbladder carcinoma undergone radical reresection following laparoscopic cholecystectomy according to presence of lymph node metastasis. P<0.05 by the log-rank test.

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