Center for Liver Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea.
World J Surg. 2010 Jul;34(7):1572-8. doi: 10.1007/s00268-010-0522-4.
Gallbladder (GB) cancer may be discovered incidentally by histopathologic examination following simple cholecystectomy. Incidental GB cancer > or =T2 or > or =N1 needs a second radical resection. It is a matter of concern whether the prognosis may be worse in patients with T2GB cancer who undergo a second radical resection than in those who undergo primary radical resection.
Between March 2001 and March 2009, 21 patients underwent a one-step operation (OSO group), and 17 patients underwent a two-step operation (TSO group) for T2GB cancer. We compared clinicopathologic factors and survival between patients in the OSO group (n = 9) and those in the TSO group (n = 9) with T2N0M0 GB cancer and between patients in the OSO group (n = 12) and those in the TSO group (n = 8) with T2N1M0 GB cancer.
Except for patient age, clinicopathologic factors as well as disease-free survival were not significantly different between the OSO group and the TSO group in the aforementioned cancer stages. Patient age was significantly higher in the OSO group than in the TSO group.
Second completion radical resection following initial simple cholecystectomy (TSO) provided a survival benefit similar to that of primary radical surgery (OSO) for patients with both T2N0M0 and T2N1M0 GB cancers in our study.
胆囊（GB）癌可能在简单的胆囊切除术后通过组织病理学检查偶然发现。偶然发现的 > or =T2 或 > or =N1 的 GB 癌需要进行第二次根治性切除术。对于接受第二次根治性切除术的 T2GB 癌患者，其预后是否比接受原发性根治性切除术的患者更差，这是一个值得关注的问题。
2001 年 3 月至 2009 年 3 月，21 例患者接受一步手术（OSO 组），17 例患者接受两步手术（TSO 组）治疗 T2GB 癌。我们比较了 OSO 组（n = 9）和 TSO 组（n = 9）中 T2N0M0GB 癌患者、OSO 组（n = 12）和 TSO 组（n = 8）中 T2N1M0GB 癌患者的临床病理因素和生存情况。
除患者年龄外，上述癌症分期的 OSO 组和 TSO 组之间的临床病理因素和无病生存率均无显著差异。OSO 组患者的年龄明显高于 TSO 组。
在我们的研究中，对于 T2N0M0 和 T2N1M0GB 癌患者，初始简单胆囊切除术后进行第二次完成性根治性切除术（TSO）提供的生存获益与原发性根治性手术（OSO）相似。
