These results demonstrate that SPT occurs in young women, and the majority of patients will experience long-term survival following resection. The only feature associated with malignant disease was tumor size at presentation. The majority of patients are alive at last follow-up, and a low percentage experienced disease recurrence or death from disease.

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Following malignant polypectomy, colectomy should be considered in medically fit patients if the polypectomy margin is positive (≤1 mm) or unknown, or if lymphovascular invasion is present.

BACKGROUND Residual disease (RD) at definitive resection of incidental gallbladder cancer (IGBCA) influences outcome, but its clinical relevance with respect to anatomic site is incompletely characterized. STUDY DESIGN Consecutive patients with IGBCA undergoing re-exploration from 1998-2009 were identified; those submitted to a complete resection were analyzed. Demographics, tumor- and treatment-related variables were correlated with RD and survival. Cancer-specific survival was stratified by site of RD [local (gallbladder bed); regional (bile duct, lymph nodes); distant (discontiguous liver, port site, peritoneal)]. RESULTS Of the 135 patients submitted to re-exploration, RD was found in 82 (61%) overall and in 63 (54%) of 116 patients submitted to resection; the most common site was regional (N=27, 43%). T stage of the gallbladder specimen was the only independent predictor of RD (T1b=35.7%,T2=48.3%,T3=70%,p=0.015). The presence of RD at any site dramatically reduced median disease-free survival (DFS) (11.2 vs. 93.4 months, p<0.0001) and disease-specific survival (DSS) (25.2 months vs. not reached, p<0.0001) compared to no RD, respectively. DSS did not differ according to RD location, with all anatomic sites being equally poor (p=0.87). RD at any site predicted DFS (HR 3.3, 95% CI 1.9-5.7, p=0.0003) and DSS (HR 2.4, 95% CI 1.2-4.6, p=0.01), independent of all other tumor-related variables. CONCLUSIONS Survival in patients with RD at local or regional sites was not significantly different than that seen in stage IV disease, with neither subgroup clearly benefiting from reoperation. Outcome was poor in all patients with RD, regardless of location.