Journal of Gastrointestinal Surgery

, Volume 14, Issue 4, pp 679–687 | Cite as

Risk Factors Influencing Recurrence, Patterns of Recurrence, and the Efficacy of Adjuvant Therapy After Radical Resection for Gallbladder Carcinoma

  • Woo Seok Kim
  • Dong Wook Choi
  • Dong Do You
  • Chuan Yu Ho
  • Jin Seok Heo
  • Seong Ho Choi
Original Article

Abstract

Backgrounds

Gallbladder carcinoma (GBC) is an aggressive neoplasm, and resection is the only curative modality. Recurrence frequently occurs after the curative resection of advanced GBC. Adjuvant treatment, particularly radiotherapy, is recommended and is used without any evidence of a beneficial effect. The aim of this study was to characterize patterns of recurrence and to identify the factors that influence recurrence and the efficacy of adjuvant therapy after the curative resection of GBC.

Methods

The records of patients that underwent surgical resection with curative intent for gallbladder carcinoma from October 1994 and August 2007 were retrospectively reviewed. Recurrence patterns, times to recurrence, and survival rates were analyzed. Sites of recurrence were identified retrospectively and categorized as locoregional or distant.

Results

One hundred sixty-six patients underwent surgical resection with curative intent for gallbladder adenocarcinoma. The 5-year recurrence rates of stages IA, IB, IIA, and IIB patients were 0%, 24.3%, 44.9%, and 58.3%, retrospectively. Positivity for lymph node metastases was found to have predictive significance for disease-free survival (p = 0.009). Regional lymph node recurrence (27.7%) was observed most frequently. There was no significant disease-free survival rates between the no adjuvant therapy and the adjuvant therapy groups.

Conclusions

The regional lymph nodes and the liver were found to be the most common sites of recurrence after curative resection. Lymph node metastases were identified as an independent predictor of tumor recurrence by multivariate analysis. Based on the disease-free survivals observed in this study, the authors find it would be difficult to advocate the routine use of adjuvant radiotherapy and/or chemotherapy

Keywords

Gallbladder carcinoma Predictive factor Lymph node metastasis Pattern of disease recurrence Adjuvant therapy 

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Copyright information

© The Society for Surgery of the Alimentary Tract 2010

Authors and Affiliations

  • Woo Seok Kim
    • 1
  • Dong Wook Choi
    • 1
    • 2
  • Dong Do You
    • 1
  • Chuan Yu Ho
    • 1
  • Jin Seok Heo
    • 1
  • Seong Ho Choi
    • 1
  1. 1.Department of Surgery, Samsung Medical Center, School of MedicineSungkyunkwan UniversitySeoulSouth Korea
  2. 2.Hepatobiliary Service, Department of SurgerySamsung Medical Center, Sungkyunkwan UniversitySeoulSouth Korea

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