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Clinicopathologic features of advanced gallbladder cancer associated with adenomyomatosis

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Abstract

Adenomyomatosis of the gallbladder has not been considered to have malignant potential, but gross features of adenomyomatosis are sometimes encountered in gallbladders resected under a diagnosis of gallbladder carcinoma. The purpose of this study was to determine the clinicopathologic features and survival rates in cases of gallbladder cancer with gross features of adenomyomatosis. The study subjects were 97 surgically treated gallbladder carcinoma patients. Only gallbladder showing typical gross features of adenomyomatosis was judged as adenomyomatosis-positive gallbladder cancer. In terms of gross findings, 25 cases (25.8%) were classified as adenomyomatosis-positive. The status of adenomyomatosis was significantly associated with the T stage (P = 0.0004), lymph node (LN) metastasis (P < 0.0001), distant metastasis (P = 0.008), and stage (P = 0.0005). In the adenomyomatosis-positive group, 16 of the 25 cases (64.0%) were classified as segmental type and 9 cases (36.0%) were classified as fundal type. No diffuse-type cases were present in this series. The status of adenomyomatosis correlated significantly with survival (P = 0.0007). However, the multivariate analysis of significant variables identified from the univariate analysis identified only T stage (P = 0.0178) and LN metastasis (P = 0.0048) as independent prognostic factors. Subset analysis with T stage according to the status of adenomyomatosis showed no significant impact on survival. These results indicate that adenomyomatosis-positive gallbladder cancer is more often diagnosed clinically in the advanced stages. Since preceding adenomyomatosis may prevent the early detection of gallbladder cancer, the usefulness of preventive cholecystectomy in cases of asymptomatic adenomyomatosis should be considered.

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Acknowledgment

This work was supported by the Ministry of Education, Culture, Sports, Science and Technology KAKENHI Grant-in-Aid for Young Scientists (B) 21791299.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Pathology and Microbiology, Faculty of Medicine, Saga University, Nabesima 5-1-1, Saga City, Saga, 849-8501, Japan

    Keita Kai, Masanori Masuda & Osamu Tokunaga

  2. Department of Surgery, Faculty of Medicine, Saga University, Saga, Japan

    Takao Ide, Kenji Kitahara, Atsushi Miyoshi, Kohji Miyazaki & Hirokazu Noshiro

Authors
  1. Keita Kai
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  2. Takao Ide
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  3. Masanori Masuda
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  4. Kenji Kitahara
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  5. Atsushi Miyoshi
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  6. Kohji Miyazaki
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  7. Hirokazu Noshiro
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  8. Osamu Tokunaga
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Correspondence to Keita Kai.

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Kai, K., Ide, T., Masuda, M. et al. Clinicopathologic features of advanced gallbladder cancer associated with adenomyomatosis. Virchows Arch 459, 573–580 (2011). https://doi.org/10.1007/s00428-011-1155-1

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  • DOI: https://doi.org/10.1007/s00428-011-1155-1

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