Sugiyama Tomohiro, Makino Kenta, Fukui Yukiko, Kinoshita Hiromitsu, Miki Akira, Uchida Shigeki, Tsubono Michihiko, Adachi Yasushi
Department of Surgery, Toyooka Hospital, Toyooka, Hyogo 668-0065, Japan.
Department of Clinical Pathology, Toyooka Hospital, Toyooka, Hyogo 668-0065, Japan.
Mol Clin Oncol. 2020 Aug;13(2):216-220. doi: 10.3892/mco.2020.2054. Epub 2020 Jun 2.
Incidental gallbladder carcinoma (IGC), defined as unexpected malignancy identified in the surgical gallbladder specimen of a cholecystectomy performed for a benign diagnosis, can be difficult to suspect preoperatively. Furthermore, there are valid clinical reasons to defer reoperation for additional resection, particularly in elderly patients. The present study aimed to determine the long-term outcomes and prognostic factors associated with recurrence in patients with IGC. The medical records of 678 patients who underwent cholecystectomy at Toyooka Hospital between September 2011 and November 2017 were reviewed. The cases identified to be IGC were retrospectively analyzed to determine patient and histopathological characteristics, surgical details, long-term outcomes and factors associated with cancer recurrence. A total of 22 patients were diagnosed with gallbladder carcinoma following cholecystectomy by histopathological examination, and 12 of these were identified to be IGC. The median age was 80 years (range 70-89 years). Although 6 of the 12 patients with IGC had stage pT2 or pT3 tumors, only 1 patient underwent additional resection. Recurrence occurred in 3 of the 8 patients who did not undergo additional resection and were available for long-term follow-up. Recurrence was not associated with the extent of tumor invasion but may be associated with other histopathological findings, preoperative treatment history and risk factors for recurrence. Furthermore, long-term survival was observed in patients with pT2 and pT3 tumors who did not undergo additional resection. Recurrence was not associated with the extent of tumor invasion but may be associated with other histopathological findings, preoperative treatment history, and risk factors for recurrence. Furthermore, long-term survival was observed in patients with pT2 and pT3 tumors who did not undergo additional resection. Even if it is a progressive IGC case, appropriate preoperative treatment or cholecystectomy without persistence of the carcinoma cell, based on a preoperative image evaluation and a postoperative histopathological examination, may greatly influence the long-term prognosis of IGC.
意外胆囊癌（IGC）被定义为在因良性诊断而进行胆囊切除术的手术胆囊标本中发现的意外恶性肿瘤，术前很难怀疑。此外，有合理的临床理由推迟再次手术以进行额外切除，尤其是在老年患者中。本研究旨在确定IGC患者的长期结局以及与复发相关的预后因素。回顾了2011年9月至2017年11月在丰冈医院接受胆囊切除术的678例患者的病历。对确诊为IGC的病例进行回顾性分析，以确定患者和组织病理学特征、手术细节、长期结局以及与癌症复发相关的因素。共有22例患者在胆囊切除术后经组织病理学检查被诊断为胆囊癌，其中12例被确定为IGC。中位年龄为80岁（范围70 - 89岁）。虽然12例IGC患者中有6例患有pT2或pT3期肿瘤，但只有1例患者接受了额外切除。在未接受额外切除且可进行长期随访的8例患者中，有3例发生了复发。复发与肿瘤浸润范围无关，但可能与其他组织病理学发现、术前治疗史和复发风险因素有关。此外，未接受额外切除的pT2和pT3期肿瘤患者观察到了长期生存。复发与肿瘤浸润范围无关，但可能与其他组织病理学发现
