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Unsuspected gallbladder carcinoma discovered during or after cholecystectomy: focus on appropriate radical re-resection according to the T-stage

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Abstract

Background

The long-term survival of patients with unsuspected gallbladder carcinoma (UGC) and the role of radical re-resection for this disease remain unclear.

Methods

A retrospective study was carried out on 38 UGC patients. The time-to-event data were demonstrated by Kaplan–Meier curves. Comparing survival curves of two groups using the log-rank test.

Results

The overall incidence of UGC in patients underwent cholecystectomy in our hospital was 0.18 % (25 of 14,073). Distribution according to actual pT-stage (the UICC) was: pT1a: n = 3; pT1b: n = 11; pT2: n = 4; pT3: n = 12; pT4: n = 8. The preoperative diagnosis included a high rate of acute biliary tract inflammation (24 of 38, 63.2 %). Compared with other gallbladder carcinoma patients, UGC group had significantly higher proportion of early stages (pT1) (36.8 %, 14 of 38 cases) (p < 0.01), and better prognosis. The comparison of radical re-resection versus simple cholecystectomy showed a significant benefit in overall survival for the pT3 group (22.0 ± 5.48 vs. 5.0 ± 0.9 months; p = 0.02). There are median survival differences between the two subgroups of patients with pT1b tumors whether received re-resection or not. Median survival was 62.0 months and 24.0 ± 8.5 months, respectively, though the differences are not statistically significant (p = 0.131).

Conclusion

Radical re-resection is strongly recommended for patients with pT1b-stage cancer. The reoperation should be performed as soon as possible, preferably within 10 days after the initial operation.

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Acknowledgments

This study was supported by the freedom exploration program of Central South University (No. 2011QNZT153), and the authors wish to thank Ming Han, MD. PhD (XiangYa hospital, Central South University) for his help in English revision of this article.

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Authors and Affiliations

  1. Department of Radiology, Xiangya Hospital, Central South University, Changsha, 410008, China

    X. Yi, X. Long & W. Li

  2. Department of General Surgery, Xiangya Hospital, Central South University, 88# Xiang Ya Road, Changsha, 410008, Hunan, China

    H. Zai & Y. Li

  3. Department of Pathology, Xiangya Hospital, Central South University, Changsha, 410008, China

    D. Xiao

Authors
  1. X. Yi
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  2. X. Long
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  3. H. Zai
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  4. D. Xiao
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  5. W. Li
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  6. Y. Li
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Corresponding author

Correspondence to Y. Li.

Additional information

This study was performed in Xiangya hospital, Central South University.

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Yi, X., Long, X., Zai, H. et al. Unsuspected gallbladder carcinoma discovered during or after cholecystectomy: focus on appropriate radical re-resection according to the T-stage. Clin Transl Oncol 15, 652–658 (2013). https://doi.org/10.1007/s12094-012-0988-7

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  • DOI: https://doi.org/10.1007/s12094-012-0988-7

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