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Benefit of extended radical surgery for incidental gallbladder carcinoma

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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.

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Abbreviations

IGC:

Incidental gallbladder carcinoma

References

  1. Hariharan D, Saied A, Kocher HM. Analysis of mortality rates for gallbladder cancer across the world. HPB (Oxford). 2008;10(5):327–31.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  2. Nimura Y. Extended surgery in bilio-pancreatic cancer: the Japanese experience. Semin Oncol. 2002;29(6 Suppl 20):17–22.

    Article  PubMed  Google Scholar 

  3. Boutros C, Gary M, Baldwin K, Somasundar P. Gallbladder cancer: past, present and an uncertain future. Surg Oncol. 2012;21(4):e183–91.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  9. Shirai Y, Yoshida K, Tsukada K, Muto T, Watanabe H. Radical surgery for gallbladder carcinoma. Long-term results. Ann Surg. 1992;216(5):565–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  13. Wysocki A, Bobrzynski A, Krzywon J, Budzynski A. Laparoscopic cholecystectomy and gallbladder cancer. Surg Endosc. 1999;13(9):899–901.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed Central  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed Central  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  21. Varshney S, Butturini G, Gupta R. Incidental carcinoma of the gallbladder. Eur J Surg Oncol. 2002;28(1):4–10.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  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.

    Article  Google Scholar 

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Conflict of interest

We have no conflicts of interest to declare.

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Authors and Affiliations

  1. Division of Digestive Surgery, Ogaki Municipal Hospital, Ogaki, Gifu, Japan

    Junpei Yamaguchi, Yuji Kaneoka, Atsuyuki Maeda, Yuichi Takayama, Shunsuke Onoe & Masatoshi Isogai

  2. Surgical Oncology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan

    Junpei Yamaguchi

Authors
  1. Junpei Yamaguchi
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  2. Yuji Kaneoka
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  3. Atsuyuki Maeda
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  4. Yuichi Takayama
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  5. Shunsuke Onoe
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  6. Masatoshi Isogai
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Correspondence to Junpei Yamaguchi.

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Yamaguchi, J., Kaneoka, Y., Maeda, A. et al. Benefit of extended radical surgery for incidental gallbladder carcinoma. Surg Today 46, 453–459 (2016). https://doi.org/10.1007/s00595-015-1198-z

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  • DOI: https://doi.org/10.1007/s00595-015-1198-z

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