| Gallbladder cancer involving the extrahepatic bile duct is worthy of resection. | |
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MedLine Citation:
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PMID: 21490453 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To clarify the value of resection of gallbladder cancer involving the extrahepatic bile duct. BACKGROUND: : Several recent studies have proven that jaundice and extrahepatic biliary involvement are independent predictors of a poor outcome. Only a few authors recommend resection of such advanced disease. METHODS: One hundred patients with pT3/4, pN0/1, M0 disease were the subjects of this study. Mortality and long-term outcome were analyzed using a prospectively collected database. RESULTS: The only factor associated with mortality in univariate and multivariate analyses was intraoperative blood loss. The 5-year survival rate and median survival time were 23% and 1.5 years for patients with pathologic extrahepatic biliary invasion (pEBI), and 54% and 15.4 years for patients without pEBI. Twelve patients with pEBI survived beyond 5 years. Multivariate analysis revealed that R1/2 resection and combined resection of adjacent organs other than the liver and extrahepatic bile duct (CRAO) were independent predictors of poor outcome. Five-year survival rate and median survival time after R0 resection without CRAO were 36% and 3.8 years even in patients with pEBI. In contrast, after R0 resection with CRAO 5-year survival and median survival time were 16% and 0.8 years, respectively. CONCLUSIONS: Patients with advanced gallbladder cancer with pEBI are candidates for resection when distant metastases are absent and R0 resection is achievable. When CRAO is unnecessary, surgical resection should be aggressively planned. |
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Authors:
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Hideki Nishio; Tomoki Ebata; Yukihiro Yokoyama; Tsuyoshi Igami; Gen Sugawara; Masato Nagino |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Annals of surgery Volume: 253 ISSN: 1528-1140 ISO Abbreviation: Ann. Surg. Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-04-14 Completed Date: 2011-06-23 Revised Date: 2012-06-25 |
Medline Journal Info:
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Nlm Unique ID: 0372354 Medline TA: Ann Surg Country: United States |
Other Details:
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Languages: eng Pagination: 953-60 Citation Subset: AIM; IM |
Affiliation:
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Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Analysis of Variance Bile Duct Neoplasms / mortality, secondary*, surgery* Bile Ducts, Extrahepatic / surgery* Cholecystectomy / adverse effects, methods* Disease-Free Survival Female Follow-Up Studies Gallbladder Neoplasms / mortality*, pathology, surgery* Humans Jaundice, Obstructive / pathology, surgery Male Middle Aged Multivariate Analysis Neoplasm Invasiveness / pathology Neoplasm Staging Postoperative Complications / physiopathology, surgery Proportional Hazards Models Prospective Studies Registries Risk Assessment Statistics, Nonparametric Survival Analysis Time Factors Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Ann Surg. 2012 Jun;255(6):e20; author reply e21
[PMID:
22566023
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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