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Surgery Today
Published in: Surgery Today 4/2016

01-04-2016 | Original Article

Benefit of extended radical surgery for incidental gallbladder carcinoma

Published in: Surgery Today | Issue 4/2016

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Abstract

Purpose

We aimed to define the benefit of extended radical surgery for incidental gallbladder carcinoma (IGC), the most appropriate treatment for which remains controversial.

Methods

We analyzed retrospectively the management strategies and prognoses of 28 patients with IGC treated in our hospital.

Results

After initial cholecystectomy, 10, 5, and 13 of the 28 patients were found to have T1a (m), T1b (mp), and T2 (ss) disease, respectively. The patients with T1a disease (T1a group) had a good prognosis; however, 9 of the 18 patients with T1b or T2 disease required additional S4a + 5 segmentectomy of the liver and bile duct resection (extended radical surgery; re-resected group), while 9 did not undergo additional treatment because of their poor general condition (no-treatment group). The re-resected group had a favorable prognosis, with an 88.9 % 5-year disease-specific survival (DSS) rate, which was significantly better than that of the non-treatment group (30.5 %, p = 0.015) and comparable to that of the T1a group (90.0 %, p = 0.97). Examination of the re-resected specimens revealed residual disease in 44 % (4/9).

Conclusion

Additional extended radical surgery improved the prognosis of patients with IGC, suggesting that there is curative potential in most cases.
Literature
1.
2.
Nimura Y. Extended surgery in bilio-pancreatic cancer: the Japanese experience. Semin Oncol. 2002;29(6 Suppl 20):17–22.CrossRefPubMed
3.
Boutros C, Gary M, Baldwin K, Somasundar P. Gallbladder cancer: past, present and an uncertain future. Surg Oncol. 2012;21(4):e183–91.CrossRefPubMed
4.
Henson DE, Albores-Saavedra J, Corle D. Carcinoma of the gallbladder. Histologic types, stage of disease, grade, and survival rates. Cancer. 1992;70(6):1493–7.CrossRefPubMed
5.
Pilgrim CH, Groeschl RT, Turaga KK, Gamblin TC. Key factors influencing prognosis in relation to gallbladder cancer. Dig Dis Sci. 2013;58(9):2455–62.CrossRefPubMed
6.
Butte JM, Matsuo K, Gonen M, D’Angelica MI, Waugh E, Allen PJ, et al. Gallbladder cancer: differences in presentation, surgical treatment, and survival in patients treated at centers in three countries. J Am Coll Surg. 2011;212(1):50–61.CrossRefPubMed
7.
Jensen EH, Abraham A, Habermann EB, Al-Refaie WB, Vickers SM, Virnig BA, et al. A critical analysis of the surgical management of early-stage gallbladder cancer in the United States. J Gastrointest Surg. 2009;13(4):722–7.CrossRefPubMed
8.
Wright BE, Lee CC, Iddings DM, Kavanagh M, Bilchik AJ. Management of T2 gallbladder cancer: are practice patterns consistent with national recommendations? Am J Surg. 2007;194(6):820–5 discussion 5–6.CrossRefPubMed
9.
10.
Ito H, Ito K, D’Angelica M, Gonen M, Klimstra D, Allen P, et al. Accurate staging for gallbladder cancer: implications for surgical therapy and pathological assessment. Ann Surg. 2011;254(2):320–5.CrossRefPubMed
11.
Frauenschuh D, Greim R, Kraas E. How to proceed in patients with carcinoma detected after laparoscopic cholecystectomy. Langenbecks Arch Surg. 2000;385(8):495–500.CrossRefPubMed
12.
Romano F, Franciosi C, Caprotti R, De Fina S, Porta G, Visintini G, et al. Laparoscopic cholecystectomy and unsuspected gallbladder cancer. Eur J Surg Oncol. 2001;27(3):225–8.CrossRefPubMed
13.
Wysocki A, Bobrzynski A, Krzywon J, Budzynski A. Laparoscopic cholecystectomy and gallbladder cancer. Surg Endosc. 1999;13(9):899–901.CrossRefPubMed
14.
Steinert R, Nestler G, Sagynaliev E, Muller J, Lippert H, Reymond MA. Laparoscopic cholecystectomy and gallbladder cancer. J Surg Oncol. 2006;93(8):682–9.CrossRefPubMed
15.
Shih SP, Schulick RD, Cameron JL, Lillemoe KD, Pitt HA, Choti MA, et al. Gallbladder cancer: the role of laparoscopy and radical resection. Ann Surg. 2007;245(6):893–901.PubMedCentralCrossRefPubMed
16.
Pawlik TM, Gleisner AL, Vigano L, Kooby DA, Bauer TW, Frilling A, et al. Incidence of finding residual disease for incidental gallbladder carcinoma: implications for re-resection. J Gastrointest Surg. 2007;11(11):1478–86 discussion 86–7.CrossRefPubMed
17.
Lendoire JC, Gil L, Duek F, Quarin C, Garay V, Raffin G, et al. Relevance of residual disease after liver resection for incidental gallbladder cancer. HPB (Oxford). 2012;14(8):548–53.PubMedCentralCrossRefPubMed
18.
Goetze TO, Paolucci V. The prognostic impact of positive lymph nodes in stages T1 to T3 incidental gallbladder carcinoma: results of the German Registry. Surg Endosc. 2012;26(5):1382–9.CrossRefPubMed
19.
Goetze TO, Paolucci V. Adequate extent in radical re-resection of incidental gallbladder carcinoma: analysis of the German Registry. Surg Endosc. 2010;24(9):2156–64.CrossRefPubMed
20.
Shibata K, Uchida H, Iwaki K, Kai S, Ohta M, Kitano S. Lymphatic invasion: an important prognostic factor for stages T1b-T3 gallbladder cancer and an indication for additional radical resection of incidental gallbladder cancer. World J Surg. 2009;33(5):1035–41.CrossRefPubMed
21.
Varshney S, Butturini G, Gupta R. Incidental carcinoma of the gallbladder. Eur J Surg Oncol. 2002;28(1):4–10.CrossRefPubMed
22.
Yildirim E, Celen O, Gulben K, Berberoglu U. The surgical management of incidental gallbladder carcinoma. Eur J Surg Oncol. 2005;31(1):45–52.CrossRefPubMed
23.
You DD, Lee HG, Paik KY, Heo JS, Choi SH, Choi DW. What is an adequate extent of resection for T1 gallbladder cancers? Ann Surg. 2008;247(5):835–8.CrossRefPubMed
24.
Bartlett DL, Fong Y, Fortner JG, Brennan MF, Blumgart LH. Long-term results after resection for gallbladder cancer. Implications for staging and management. Ann Surg. 1996;224(5):639–46.PubMedCentralCrossRefPubMed
25.
Pawlik TM, Choti MA. Biology dictates prognosis following resection of gallbladder carcinoma: sometimes less is more. Ann Surg Oncol. 2009;16(4):787–8.CrossRefPubMed
26.
Araida T, Higuchi R, Hamano M, Kodera Y, Takeshita N, Ota T, et al. Should the extrahepatic bile duct be resected or preserved in R0 radical surgery for advanced gallbladder carcinoma? Results of a Japanese Society of Biliary Surgery Survey: a multicenter study. Surg Today. 2009;39(9):770–9.CrossRefPubMed
27.
Chatelain D, Fuks D, Farges O, Attencourt C, Pruvot FR, Regimbeau JM. Pathology report assessment of incidental gallbladder carcinoma diagnosed from cholecystectomy specimens: results of a French multicentre survey. Dig Liver Dis. 2013;45(12):1056–60.CrossRefPubMed
28.
Horiguchi A, Miyakawa S, Ishihara S, Miyazaki M, Ohtsuka M, Shimizu H, et al. Gallbladder bed resection or hepatectomy of segments 4a and 5 for pT2 gallbladder carcinoma: analysis of Japanese registration cases by the study group for biliary surgery of the Japanese Society of Hepato-Biliary–Pancreatic Surgery. J Hepatobiliary Pancreat Sci. 2013;20(5):518–24.CrossRefPubMed
29.
Goetze TO, Paolucci V. Prognosis of incidental gallbladder carcinoma is not influenced by the primary access technique: analysis of 837 incidental gallbladder carcinomas in the German Registry. Surg Endosc. 2013;27(8):2821–8.CrossRefPubMed
30.
Fuks D, Regimbeau JM, Pessaux P, Bachellier P, Raventos A, Mantion G, et al. Is port-site resection necessary in the surgical management of gallbladder cancer? J Visc Surg. 2012;150(4):277–84.CrossRef
Metadata
Title
Benefit of extended radical surgery for incidental gallbladder carcinoma
Publication date
01-04-2016
Published in
Surgery Today / Issue 4/2016
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-015-1198-z

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