Radical Second Resection Provides Survival Benefit for Patients with T2 Gallbladder Carcinoma First Discovered after Laparoscopic Cholecystectomy

Wakai, Toshifumi; Shirai, Yoshio; Hatakeyama, Katsuyoshi

doi:10.1007/s00268-002-6274-z

Cited by 117 publications

(80 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For pT2 or more advanced tumors, many authors advocate radical resection with lymph node dissection [10][11][12][13][14] . Previous reports have shown a second radical resection to be associated with significantly better survival than cholecystectomy alone in pT2 GBCa patients whose cancers were incidentally found after cholecystectomy [15][16][17][18] , whereas, Wakai et al [19] have reported that 40.5% of patients with unapparent pT2 tumors survived > 5 years after cholecystectomy alone. S4a5 hepatectomy combined with extra-hepatic bile duct resection (BDR) and D2 lymph node dissection is a highly recommended operation for the treatment of T2 and T3 GBCa [6] , although, in T2 GBCa, the surgical procedure remains controversial, and there is no standard operation.…”

Section: Introductionmentioning

confidence: 86%

Rational therapeutic strategy for T2 gallbladder carcinoma based on tumor spread

Kohya

Kono²,

Miyazaki

2010

WJG

View full text Add to dashboard Cite

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.

show abstract

Section: Introductionmentioning

confidence: 86%

Rational therapeutic strategy for T2 gallbladder carcinoma based on tumor spread

Kohya

Kono²,

Miyazaki

2010

WJG

View full text Add to dashboard Cite

show abstract

“…However, LC may increase the risk of port site recurrence and peritoneal dissemination as a result of bile leak associated with gallbladder injury [159][160][161]. In patients with incidental gallbladder carcinoma, which is found after cholecystectomy, the ratio of port site recurrence or peritoneal dissemination is reported relatively high with 10-18% and the period until recurrence is relatively short with 6-10 months [162][163][164][165][166][167][168][169][170].…”

Section: Cq16: What Are Considered As Unresectable Factors In Biliarymentioning

confidence: 99%

“…On the other hand, in gallbladder carcinoma invading the subserosal layer, high rates of vascular and perineural invasion and lymph node involvement are observed [180][181][182][183][184][185]. In fact, there are many reports that have showed an additional resection improved the prognosis of patients with incidental gallbladder carcinoma [167,168,[186][187][188][189]. Therefore, an additional resection including hepatectomy and lymph node dissection should be considered for patients with incidental gallbladder carcinoma invading subserosal layer or more.…”

Section: Cq16: What Are Considered As Unresectable Factors In Biliarymentioning

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

Self Cite

234

165

View full text Add to dashboard Cite

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

show abstract

“…Of all GBC 27-41 % are IGBC [6]. Most of these cases unsuspected pre-operatively belong to the category of pT1 and pT2 (early GBC) [7]. Many of these patients with disease labeled as IGBC have a radiological diagnosis suspicious for GBC, which has been over looked by the surgeon and the patient has been treated with a simple cholecystectomy alone.…”

Section: Definition and Incidence Of Incidental Gallbladder Cancermentioning

confidence: 99%

Incidentally Detected Gallbladder Cancer- The Controversies and Algorithmic Approach to Management

et al. 2012

View full text Add to dashboard Cite

Incidentally discovered gallbladder cancer (IGBC) is defined as the gallbladder cancer (GBC) diagnosed during or after the cholecystectomy done for unsuspected benign gallbladder disease. Laparoscopic cholecystectomy (LC) is the most common procedure performed for benign gallbladder disease worldwide. Majority of GBC patients have associated gallstones. With the advent of ultrasonography more patients are being diagnosed with gallstones and are being subjected to cholecytectomy. IGBC is found in 0.2-2.9 % of all cholecytectomies done for gallstone disease. It represents 27-41 % of all GBC. Patients with IGBC having Tis and T1a stage, with negative cystic duct margin can be treated by simple cholecystectomy alone. Patients with stage T1b and beyond should undergo restaging, and should be treated with radical re -resection (R0). Residual disease is found in 40-76 % patients on re-exploration. The survival rates of patients undergoing re resection for IGBC is similar to those undergoing primary radical surgery. LC is contraindicated in patients with GBC. Patients presenting post LC should undergo radical re-resection and additional port site excision, as they have a high incidence of port site metastasis. At cholecystectomy for benign gallbladder disease all gallbladder specimens should be opened before closing abdomen and if available all suspicious specimens should be sent for immediate frozen section. All gallbladder specimens should be subjected to histopathology examination to avoid missing GBC. The surgeon should have a high index of suspicion for GBC if encountering difficult cholecystectomy for a benign disease, and in patients with atypical clinical and ultrasound findings in high incidence areas.

show abstract

Radical Second Resection Provides Survival Benefit for Patients with T2 Gallbladder Carcinoma First Discovered after Laparoscopic Cholecystectomy

Cited by 117 publications

References 29 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

Incidentally Detected Gallbladder Cancer- The Controversies and Algorithmic Approach to Management

Contact Info

Product

Resources

About

Radical Second Resection Provides Survival Benefit for Patients with T2 Gallbladder Carcinoma First Discovered after Laparoscopic Cholecystectomy

Cited by 117 publications

References 29 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

Incidentally Detected Gallbladder Cancer- The Controversies and Algorithmic Approach to Management

Contact Info

Product

Resources

About

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