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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2014

01-12-2014 | Hepatobiliary Tumors

Surgical Approaches to Advanced Gallbladder Cancer

A 40-Year Single-Institution Study of Prognostic Factors and Resectability

Authors: Ryota Higuchi, MD, PhD, Takehiro Ota, MD, PhD, Tatsuo Araida, MD, PhD, Hideki Kajiyama, MD, Takehisa Yazawa, MD, PhD, Toru Furukawa, MD, PhD, Tatsuya Yoshikawa, MD, PhD, Ken Takasaki, MD, PhD, Masakazu Yamamoto, MD, PhD

Published in: Annals of Surgical Oncology | Issue 13/2014

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Abstract

Purpose

The aim was to evaluate prognostic factors and factors associated with the resectability of advanced gallbladder cancer (GBC).

Methods

This was a single-institution retrospective review of 274 consecutive surgically-treated cases of advanced GBC (excluding incidental GBC and early GBC). Univariate and multivariate analysis were performed to assess prognostic variables. R0 resection and survival rates were investigated for each local extension factor.

Results

Long-term survival was uncommon among patients with multiple liver metastases (H2–3: n = 22; 2-year survival, 0 %), dissemination (P1–3: n = 16; 3-year survival, 0 %), invasion through the hepatoduodenal ligament (Binf3: n = 45; 5-year survival, 4.6 %), or group 3 lymph node (LN) metastasis including of the para-aortic LN (N3: n = 52; 13.7 %). Long-term survival rates did not differ significantly between patients who did and did not undergo bile duct resection or pancreaticoduodenectomy. Survival did not differ significantly according to the type of hepatectomy performed.

Conclusion

Surgery may not be indicated for patients with multiple liver metastasis, dissemination, Binf3, or visible para-aortic LN metastasis. Furthermore, it is important to achieve R0 surgery in cases of GBC.
Appendix
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Metadata
Title
Surgical Approaches to Advanced Gallbladder Cancer
A 40-Year Single-Institution Study of Prognostic Factors and Resectability
Authors
Ryota Higuchi, MD, PhD
Takehiro Ota, MD, PhD
Tatsuo Araida, MD, PhD
Hideki Kajiyama, MD
Takehisa Yazawa, MD, PhD
Toru Furukawa, MD, PhD
Tatsuya Yoshikawa, MD, PhD
Ken Takasaki, MD, PhD
Masakazu Yamamoto, MD, PhD
Publication date
01-12-2014
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 13/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-3885-1

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