TITLE

Lymphatic Invasion: An Important Prognostic Factor for Stages T1b–T3 Gallbladder Cancer and an Indication for Additional Radical Resection of Incidental Gallbladder Cancer

AUTHOR(S)
Shibata, Kohei; Uchida, Hiroki; Iwaki, Kentaro; Kai, Seiichiro; Ohta, Masayuki; Kitano, Seigo
PUB. DATE
May 2009
SOURCE
World Journal of Surgery;May2009, Vol. 33 Issue 5, p1035
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Laparoscopic cholecystectomy is being performed with increasing frequency worldwide. This has led to more frequent discovery of incidental gallbladder cancer (IGBC) and in turn to the need for an independent prognostic factor for stages T1b–T3 gallbladder cancer so that is can be determined clinically which cases of IGBC are indicated for additional radical resection (ARR). A retrospective study was conducted that included 72 patients who underwent macroscopically curative surgical resection (R0, R1) at our center for stages T1b–T3 GBC. Survival analysis was performed, and the usefulness of ARR was analyzed in 15 patients with IGBC. Univariate analysis of disease-specific survival showed stage T3, histologic grade II–IV, lymphatic invasion, vessel invasion, perineural invasion, lymph node metastasis, and a positive resection margin to be factors indicative of poor prognosis. Independent predictors of poor disease-specific survival were stage T3 (hazard ratio, 2.33 [95% CI, 1.10–4.95]), lymphatic invasion (5.97 [1.29–27.6]), and a positive resection margin (3.17 [1.51–6.63]). Among the 15 IGBC patients, 4 of 5 patients without lymphatic invasion were cured, 2 of whom underwent cholecystectomy alone; 4 of 10 patients with lymphatic invasion did not undergo ARR, and the cancer recurred in all 4 patients; the other 6 patients underwent ARR, and 4 of them were cured by reoperation. Lymphatic invasion well reflects the malignant phenotype of stages T1b–T3 GBC. We advocate ARR for IGBC patients with lymphatic invasion.
ACCESSION #
37827216

 

Related Articles

  • Strawberry gallbladder - poorly known pathomorphological aspects. Sośnik, Henryk; Sośnik, Katarzyna // Gastroenterologia Polska / Gastroenterology;2008, Vol. 15 Issue 2, p101 

    Aim of study: Cholesterolosis is well known but some aspects on it have not been investigared. The aim of the study was to determine the frequency of cholesterolosis occurrence during the process of aging and its role in the development of gallbladder dysplasia. Material and methods: From among...

  • Short-term effects of gallbladder perforations during laparoscopic cholecystectomy on respiratory mechanics and depth of pain. Kalayci, Mustafa Uygar; Akin, Baris Veli; Alis, Halil; Kapan, Selin; Turhan, Ahmet Nuray; Aygun, Ersan // Surgical Endoscopy;May2008, Vol. 22 Issue 5, p1317 

    In this study the effects of gallbladder perforations during laparoscopic cholecystectomy on respiratory mechanics and depth of pain in the postoperative period was evaluated. Between April 2004 and February 2006 we planned to perform 179 laparoscopic cholecystectomies. One hundred of these...

  • Persistent Portal Venous Gas Huurman, Volkert A.L.; Visser, Leo G.; Steens, Stefan C.A.; Terpstra, Onno T.; Schaapherder, Alexander F.M. // Journal of Gastrointestinal Surgery;May2006, Vol. 10 Issue 5, p783 

    This case report describes a patient diagnosed with ongoing portal venous gas, initiated by a rather common Campylobacter enterocolitis and maintained by septic thrombophlebitis and possibly by chronic cholecystitis. Cholecystectomy attenuated the patient''s septic condition. The etiology of...

  • Needlescopic surgery for liver, gallbladder and spleen diseases. Tagaya, Nobumi; Abe, Akihito; Kubota, Keiichi // Journal of Hepato -- Biliary -- Pancreatic Sciences;Jul2011, Vol. 18 Issue 4, p516 

    Background: We propose that needlescopic surgery (NS) should be considered as a way of improving the esthetic result and post-operative quality of life of patients and of reducing costs and stress on surgeons, and we have evaluated the results of NS. Methods: We used NS in 157 patients between...

  • Our initial experience with robotic hepato-biliary-pancreatic surgery. Wakabayashi, Go; Sasaki, Akira; Nishizuka, Satoshi; Furukawa, Toshiharu; Kitajima, Masaki // Journal of Hepato -- Biliary -- Pancreatic Sciences;Jul2011, Vol. 18 Issue 4, p481 

    Background: The authors performed Asia's first robotic surgery in March 2000 and a clinical trial was launched in the following year in order to obtain governmental approval for the da Vinci Surgical System. Methods: Fifty-two robotic surgeries were performed at Keio University Hospital, of...

  • Filtered signal-averaged P-wave duration during pneumoperitoneum in patients undergoing laparoscopic cholecystectomy: A reflection of pathophysiological cardiac changes. Bickel, Amitai; Marinovski, Michael; Shturman, Alexander; Roguin, Nathan; Waksman, Igor; Eitan, Arie // Surgical Endoscopy;Jan2008, Vol. 22 Issue 1, p221 

    Induction of pneumoperitoneum (PP) may lead to adverse cardiac functions secondary to changes such as decreased venous return and hypercarbia. The assessment of cardiac electrical activity by signal averaging may reflect various hemodynamic derangements and serve as a prognostic marker for...

  • Transcylindrical gas-free cholecystectomy for the treatment of cholelithiasis, cholecystitis, and choledocholithiasis. Grau-Talens, Enrique-Javier; Giner, Manuel // Surgical Endoscopy;Sep2010, Vol. 24 Issue 9, p2099 

    Background: Laparoscopic cholecystectomy (LC) has become the standard for treatment of uncomplicated cholecystolithiasis. However, in cases of cholecystitis or cholecysto-choledocholithiasis, technical and skill requirements may make questionable the convenience of laparoscopy. Transcylindrical...

  • Laparoscopic cholecystectomy accompanied by simultaneous umbilical hernia repair. Wright, B. E. // Journal of Postgraduate Medicine;Jul-Sep2007, Vol. 53 Issue 3, p156 

    The article presents a commentary on the paper published within the issue on laparoscopic cholecystectomy accompanied by simultaneous umbilical hernia repair. The author notes that while the gold standard for the treatment of bothersome gallstones is well established, the repair for the...

  • Single-incision laparoscopic cholecystectomy- initial experience with different multichannel ports. Ražnatović, Zoran J.; Zarić, Nemanja D.; Djurašić, Ljubomir M.; Lekić, Nebojša S.; Djordjević, Vladimir R.; Radojković, Željko Z.; Veselinović, Milan D.; Duka, Slobodan V.; Kerkez, Mirko D. // Acta Chirurgica Iugoslavica;2012, Vol. 59 Issue 1, p67 

    Single-incision laparoscopic cholecystectomy is a relatively new minimally invasive surgical technique in treatment of benign gallbladder diseases. It considered a bridge technique between conventional laparoscopic cholecystectomy (LC) and NOTES. We are presenting our initial experiences in SILC...

Share

Read the Article

Courtesy of NEW JERSEY STATE LIBRARY

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics