Carcinoma of the Gallbladder

Donohue, John H.; Nagorney, David M.; Grant, Clive S.; Tsushima, K; Ilstrup, Duane M.; Adson, Martin A.

doi:10.1001/archsurg.1990.01410140115019

Cited by 209 publications

(25 citation statements)

References 30 publications

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“…In the Mayo Clinic series [30], 36% of 11 1 patients underwent resection. Cholecystectomy was performed in 20% and radical cholecystectomy in 16%.…”

Section: Surgical Managementmentioning

confidence: 99%

“…There were no long-term survivors. The Mayo Clinic data [30] suggest that although there was no survival difference in patients having radical cholecystectomy vs. cholecystectomy , overall there was a difference in favor of radical cholecystectomy in patients who had transmural extension or who had lymph node metastases (Table 11).…”

Section: Management Of Inapparent or Occultmentioning

confidence: 99%

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Carcinoma of the gallbladder

Wanebo

Vezeridis

1993

J. Surg. Oncol.

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“…In the Mayo Clinic series [30], 36% of 11 1 patients underwent resection. Cholecystectomy was performed in 20% and radical cholecystectomy in 16%.…”

Section: Surgical Managementmentioning

confidence: 99%

Section: Management Of Inapparent or Occultmentioning

confidence: 99%

Carcinoma of the gallbladder

Wanebo

Vezeridis

1993

J. Surg. Oncol.

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“…However, the extent of surgical procedures remains controversial, particularly after incidental findings or in advanced stages of disease [13,21,22]. Some reasons for this are the lack of a uniform classification of staging systems in previous reports [23-25] and a different use of terms like "extended cholecystectomy" and "extended resection" which included various surgical procedures in some studies [7,23,26]. The 5- year survival rate following surgery for GBC is reported to be 5-13% in the recent literature [1,2,27] except a study of a small number of cases [2].…”

Section: Discussionmentioning

confidence: 99%

The time of diagnosis impacts surgical management but not the outcome of patients with gallbladder Carcinoma

Löhe

Meimarakis

Schauer³

et al. 2009

Eur J Med Res

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Background Only 50% of gallbladder cancers (GBC) are recognized before operation and the remaining tumors are diagnosed during surgery or afterwards by the pathologist. These situations may demand substantial modifications of the proceeding during surgery as well as the need for reoperation in some cases. Therefore, the time of diagnosis may strongly influence the surgical management of GBC and the prognosis of the patients. Methods Records and follow-up of 152 patients with gallbladder carcinoma who underwent surgery between 1980 and 2004 were examined according to the time of diagnosis, TNM staging system, surgical procedures, morbidity and predictors of survival. There were 76 patients with preoperative diagnosis of GBC (50%; group1), 44 patients with intraoperative diagnosis (29%; group 2) and 32 patients (21%; group 3) with postoperatively incidental finding of GBC. In all cases radical resection of the GBC was intended, except in 5 patients from group 1. Surgical procedures comprised from simple cholecystectomy to multivisceral resections. Results Overall 5-year survival rate was 7% with a significantly better median survival in group 3 (53.2 month), when compared to only 6.1 month (group 2) and 5.4 month (group 1), respectively. Findings at operation forced significant modifications of the surgical strategy in 85%. Complete resection of GBC was achieved in 38% of the patients. Stage- dependent survival was comparable between the groups following R0 resection. Tumor stage, in particular the nodal status and radicality of the procedure, but not the time of diagnosis were the most powerful predictors of outcome. Conclusions Complete tumor resection may provide long-term survival even in locally advanced GBC. Although the time of diagnosis of GBC causes significant changes of the intended procedures during and after surgery, it has no influence on the prognosis provided that radical (R0) resection was accomplished.

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“…Während frühere Studien mit oftmals geringen Fallzahlen insbesondere bei fortgeschritten nodal-positiven Patienten keinen Überlebensvorteil nachweisen konnten und allenfalls für Patienten mit einem T4N0 ein Langzeitüberleben berichtet wurde, haben neueste Publikationen auch bei lokal fortgeschrittenen Tumoren mit einem reinhilären und/oder regionären LK-Befall (N1-/N2-Status) tumorfreie 5-Jahres-Überlebensraten von 22-25% berichtet [7,11] …”

Section: Vor Allem Patienten Im Stadium II Profitieren Von Der Radikaunclassified

Inzidentalome der Leber und der Gallenblase

Zülke

2007

Chirurg

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The expanding use of ultrasound in general practice is leading to an ever increasing rate of detection of true hepatic incidentaloma. The correct diagnosis of hepatic incidentaloma may be made in over 90% with non-invasive means. The questionable diagnosis of "symptomatic" incidentaloma should undergo close scrutiny prior to a decision in favour of surgery. With regard to more recent literature, the former "absolute" requirement for surgical resection in all cases of liver cell adenoma may have to be reappraised. Final inability to rule out malignancy represents an unquestionable indication for surgery in the light of low rates of morbidity and lack of mortality in this otherwise healthy patient group. Percutaneous biopsies should not be performed due to oncological hazards, indeterminate results and potential for acute complications.The stage-oriented radical re-resection following diagnosis of an incidentally detected gallbladder cancer may lead to significantly improved long-term survival, especially in the early tumour stages T1b and T2, which represents the most common stage of gallbladder cancer in incidentaloma. Patients at elevated risk for incidental gallbladder cancer should undergo thorough instruction with regard to the potential hazards of laparoscopic cholecystectomy. Multimodal therapeutic strategies directed at advanced stages of incidentally detected gallbladder cancer should be evaluated in prospective multicentre studies.

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Carcinoma of the Gallbladder

Cited by 209 publications

References 30 publications

Carcinoma of the gallbladder

Carcinoma of the gallbladder

The time of diagnosis impacts surgical management but not the outcome of patients with gallbladder Carcinoma

Inzidentalome der Leber und der Gallenblase

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