Gil Luis, Lendoire Javier, Duek Fernando, Quarin Carlos, Garay Verónica, Raffin Gabriel, Rivaldi Marcelo, Imventarza Oscar
Del Programa de Trasplante Hepático, Hospital General de Agudos Dr. Cosme Argerich, Ciudad Autónoma de Buenos Aires, Argentina.
Del Programa de Trasplante Hepático, Hospital General de Agudos Dr. Cosme Argerich, Ciudad Autónoma de Buenos Aires, Argentina.
Cir Esp. 2014 Mar;92(3):168-74. doi: 10.1016/j.ciresp.2013.11.010. Epub 2014 Jan 17.
Surgical treatment of gallbladder cancer is still controversial. The extent of the radical surgery and its therapeutic efficacy continue to be debated.
Analyze the efficacy of radical resection in patients with incidental gallbladder cancer evaluating the presence of residual disease in the resection specimen and analyzing the associated factors of survival.
A retrospective analysis of patients with incidental GC between June 1999 and June 2010 was performed. Incidental (I) tumors were included. Data covering demographic features, clinical characteristics, local pathological stage, histological features and factors for long term survival were analyzed. p< 0.05 were considered significant.
A total of 28 patients: 78,6% females. Median age 56 years. All treated by resection of segments 4b/5 and lymphadenectomy. Histological examination revealed residual disease in 42% (37% liver), residual disease was related to tumoral (T) stage (p 0,001). Patients with residual disease presented a DSS and DFS of 10 and 6.5 months respectively vs 56 months in those without residual disease (p 0,001). Variables associated with survival were T stage (P .006), TNM stage (P<.001), and residual disease in the resected specimen (P<.001).
Aggressive re-resection of incidental GC offers the only chance for cure but its efficacy depends on the extent of the disease found at the time of repeated surgery and in the deferred pathological study.
胆囊癌的手术治疗仍存在争议。根治性手术的范围及其治疗效果仍在讨论中。
分析意外胆囊癌患者根治性切除的疗效，评估切除标本中残留疾病的存在情况，并分析生存相关因素。
对1999年6月至2010年6月期间的意外胆囊癌患者进行回顾性分析。纳入意外（I）肿瘤患者。分析涵盖人口统计学特征、临床特征、局部病理分期、组织学特征和长期生存因素的数据。p<0.05被认为具有统计学意义。
共28例患者，女性占78.6%，中位年龄56岁。均接受4b/5段切除及淋巴结清扫术。组织学检查显示42%存在残留疾病（37%为肝脏残留），残留疾病与肿瘤（T）分期相关（p=0.001）。有残留疾病的患者的疾病特异性生存（DSS）和无病生存（DFS）分别为10个月和6.5个月，而无残留疾病的患者为56个月（p=0.001）。与生存相关的变量为T分期（P=0.006）、TNM分期（P<0.001）和切除标本中的残留疾病（P<0.001）。
对意外胆囊癌进行积极的再次切除是治愈的唯一机会，但其疗效取决于再次手术时发现的疾病范围以及延迟病理研究结果。
