Incidental Gallbladder Cancer on Cholecystectomy: Strategy for Re-resection of Presumed Benign Diseases from a Retrospective Multicenter Study by the Yokohama Clinical Oncology Group
| Autor: | Goro Matsuda, Ryusei Matsuyama, Mitsutaka Sugita, Itaru Endo, Toru Kubota, Kenichi Matsuo, Noriyuki Kamiya, Yasuhisa Mochizuki, Ryo Takagawa, Kunio Kameda, Toshiaki Kadokura, Ryutaro Mori, Naotaka Yamaguchi |
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| Rok vydání: | 2020 |
| Předmět: |
Cancer Research
medicine.medical_specialty Multivariate analysis medicine.medical_treatment Disease Medical Oncology Re resection General Biochemistry Genetics and Molecular Biology 03 medical and health sciences 0302 clinical medicine Medicine Humans Cholecystectomy Gallbladder cancer Pathological Presumed Benign Neoplasm Staging Retrospective Studies Pharmacology Incidental Findings business.industry General surgery medicine.disease Bile spillage Cholecystectomy Laparoscopic 030220 oncology & carcinogenesis Gallbladder Neoplasms business Research Article |
| Zdroj: | In Vivo |
| ISSN: | 1791-7549 |
| Popis: | Background/aim Current expert consensus recommends re-resection for incidental gallbladder cancer (IGBC) of pT1b-3. This study examined whether this consensus was reasonably applicable to patients with IGBC in one Japanese region. Patients and methods This was a multicenter, retrospective analysis of cholecystectomies for presumed benign diseases between January 2000 and December 2009. Results IGBC was diagnosed in 70 (1.0%) out of 6,775 patients undergoing cholecystectomy. Five-year disease-specific cumulative survival was 100% in 19 patients with pT1a, 80.0% in five with pT1b, 49.5% in 33 with pT2, and 23.1% in 13 with pT3. Re-resection was not performed for the 24 patients with pT1a/1b disease, whereas 24 out of 46 patients with pT2/3 underwent re-resection. Regardless of re-resection, independent factors associated with a poor prognosis on multivariate analysis were grade 2 or poorer disease and bile spillage at prior cholecystectomy. In the 24 patients with pT2/3 re-resection, 11 patients without either of these two factors had significantly better 5-year disease-specific cumulative survival than the 13 patients with one or two independent factors associated with a poor prognosis (72.7% vs. 30.8%, p=0.009). Conclusion This Japanese regional study suggests that indication of re-resection for IGBC should not be determined by pT-factor alone and that much more attention should be paid to pathological and intraoperative findings at prior cholecystectomy. |
| Databáze: | OpenAIRE |
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