Surgical Strategy for T2 Gallbladder Cancer: Nationwide Multicenter Survey in Korea
Journal of Korean Medical Science
;
: e186-2018.
Article
Dans Anglais
| WPRIM
| ID: wpr-716044
ABSTRACT
BACKGROUND:
Although all guidelines suggest that T2 gallbladder (GB) cancer should be treated by extended cholecystectomy (ECx), high-level scientific evidence is lacking because there has been no randomized controlled trial on GB cancer.METHODS:
A nationwide multicenter study between 2000 and 2009 from 14 university hospitals enrolled a total of 410 patients with T2 GB cancer. The clinicopathologic findings and long-term follow-up results were analyzed after consensus meeting of Korean Pancreas Surgery Club.RESULTS:
The 5-year cumulative survival rate (5YSR) for the patients who underwent curative resection was 61.2%. ECx group showed significantly better 5YSR than simple cholecystectomy (SCx) group (65.4% vs. 54.0%, P = 0.016). For N0 patients, there was no significant difference in 5YSR between SCx and ECx groups (68.7% vs. 73.6%, P = 0.173). Systemic recurrence was more common than locoregional recurrence (78.5% vs. 21.5%). Elevation of cancer antigen 19-9 level preoperatively and lymph node (LN) metastasis were significantly poor prognostic factors in a multivariate analysis.CONCLUSION:
ECx including wedge resection of GB bed should be recommended for T2 GB cancer. Because systemic recurrence was more common and recurrence occurred more frequently in patients with LN metastasis, postoperative adjuvant therapy should be considered especially for the patients with LN metastasis.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Pancréas
/
Récidive
/
Cholécystectomie
/
Analyse multifactorielle
/
Taux de survie
/
Études de suivi
/
Consensus
/
Vésicule biliaire
/
Tumeurs de la vésicule biliaire
/
Hôpitaux universitaires
Type d'étude:
Essai clinique contrôlé
/
Guide de pratique
/
Étude observationnelle
/
Étude pronostique
Limites du sujet:
Humains
Pays comme sujet:
Asie
langue:
Anglais
Texte intégral:
Journal of Korean Medical Science
Année:
2018
Type:
Article
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