Outcome of radical surgery for carcinoma of the gallbladder according to the TNM stage

Tsukada, Kazuhiro; Hatakeyama, Katsuyoshi; Kurosaki, Isao; Uchida, Katsuyuki; Shirai, Yoshio; Muto, Terukazu; Yoshida, Kazuhiko

doi:10.1016/s0039-6060(96)80089-4

Cited by 181 publications

(158 citation statements)

References 21 publications

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“…Surgical management of T1 GBCa reveals almost no lymph node involvement and shows a relatively sufficient 5-year survival rate of 82%-100% with simple cholecystectomy [8,9,19] . A: Disease-specific survival; the 5-year survival rate for ss min and ss med was 100%.…”

Section: Discussionmentioning

confidence: 99%

“…However, the overall 5-year survival rate is 5%-42.3%, even after radical resection of the tumor [1,2,5,6] . The prognosis for patients with early GBCa, defined as pT1a/b lesions, shows a 5-year survival rate of 82%-100% [6][7][8][9] . Due to the anatomical proximity to important organs, surgery for advanced gallbladder cancer requires an aggressive approach.…”

Section: Introductionmentioning

confidence: 99%

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Rational therapeutic strategy for T2 gallbladder carcinoma based on tumor spread

Kohya

Kono²,

Miyazaki

2010

WJG

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AIM:To evaluate the adequacy of surgical treatment of T2 gallbladder carcinoma (GBCa) according to tumor spread in the subserosal layer. METHODS:A series of 84 patients with GBCa were treated at Saga University Hospital, Japan between April 1989 and October 2008. The tumor stage was graded according to the TNM staging for GBCa from the American Joint Committee on Cancer Manual 6th edition. Tumor staging revealed 30 patients with T2 tumors. T2 GBCa was divided into three groups histologically by the extent of tumor spread in the subserosal layer, using a score of ss minimum (ss min), ss medium (ss med) or ss massive (ss mas). RESULTS:For ss min GBCa, there was no positive pathological factor and patient survival was satisfactory with simple cholecystectomy, with or without extra-hepatic bile duct resection. For ss med GBCa, some pathological factors, h-inf (hepatic infiltration), ly (lymphatic invasion) and n (lymph node metastasis), were positive. For ss mas GBCa, there was a high incidence of positive pathological factors. The patient group with extra-hepatic bile duct resection with D2 lymph node dissection (BDR with D2) and those with S4a5 hepatectomy had significantly better survival rates. CONCLUSION:We suggest that radical surgery is not necessary for ss min GBCa, and partial hepatectomy and BDR are necessary for both ss med and ss mas GBCa.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Rational therapeutic strategy for T2 gallbladder carcinoma based on tumor spread

Kohya

Kono²,

Miyazaki

2010

WJG

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“…(Grade 2, evidence level C) Statement: There is no obvious evidence which shows that combined extrahepatic bile duct resection improves the prognosis of the patients with a gallbladder carcinoma without direct invasion to the hepatoduodenal ligament in preoperative diagnosis [212]. On the other hand, several studies show that lymphatic infiltration around the bile duct is the most important pathway for cancer spread in these diseases and distant microscopic spread separated from the primary tumor is often found [182,213]. It may indicate that the combined extrahepatic resection increases the curative resection rate in patients with cancer invading the neck of gallbladder, involving lymph node, or associating with perineural infiltration [175,180,214].…”

Section: Cq23: Is the Local Resection Or Papillectomy (Surgical Or Enmentioning

confidence: 99%

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Miyazaki

Yoshitomi

Miyakawa³

et al. 2015

J Hepato Biliary Pancreat

234

165

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Background The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract and ampullary carcinomas in 2008. Novel treatment modalities and handling of clinical issues have been proposed after the publication. New approaches for editing clinical guidelines, such as the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, also have been introduced for better and clearer grading of recommendations. Methods Clinical questions (CQs) were proposed in seven topics. Recommendation, grade of recommendation and statement for each CQ were discussed and finalized by evidencebased approach. Recommendation was graded to grade 1 (strong) and 2 (weak) according to the concept of GRADE system. Results The 29 CQs covered seven topics: (1) prophylactic treatment, (2) diagnosis, (3) biliary drainage, (4) surgical treatment, (5) chemotherapy, (6) radiation therapy, and (7) pathology. In 27 CQs, 19 recommendations were rated strong and 11 recommendations weak. Each CQ included the statement of how the recommendation was graded. Conclusions This guideline provides recommendation for important clinical aspects based on evidence. Future collaboration with cancer registry will be a key for assessment of the guidelines and establishment of new evidence. Free full-text articles and a mobile application of this guideline are available via

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“…While some surgeons have advocated routine resection of the common bile duct at the time of curative resection and portal lymphadenectomy, other investigators have questioned this approach. 1,6,7 The study by D'Angelica et al, as well as others, now provide data to show that routine bile duct excision is not necessarily associated with improved overall survival. 6,8 The notion that resection of the common bile duct may facilitate a more thorough lymphadenectomy also has been questioned.…”

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confidence: 96%

Biology Dictates Prognosis Following Resection of Gallbladder Carcinoma: Sometimes Less is More

Pawlik

Choti

2009

Ann Surg Oncol

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Outcome of radical surgery for carcinoma of the gallbladder according to the TNM stage

Cited by 181 publications

References 21 publications

Rational therapeutic strategy for T2 gallbladder carcinoma based on tumor spread

Rational therapeutic strategy for T2 gallbladder carcinoma based on tumor spread

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Biology Dictates Prognosis Following Resection of Gallbladder Carcinoma: Sometimes Less is More

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Outcome of radical surgery for carcinoma of the gallbladder according to the TNM stage

Cited by 181 publications

References 21 publications

Rational therapeutic strategy for T2 gallbladder carcinoma based on tumor spread

Rational therapeutic strategy for T2 gallbladder carcinoma based on tumor spread

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2nd English edition

Biology Dictates Prognosis Following Resection of Gallbladder Carcinoma: Sometimes Less is More

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Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition