Gallbladder cancer invading the perimuscular connective tissue: results of reresection after prior non-curative operation.

摘要

BACKGROUND AND OBJECTIVES: Most T2 gallbladder cancers are diagnosed at final pathology after cholecystectomy. Reoperations including liver resection and regional lymph node dissection are needed to achieve better long-term results. The aim of this study is to evaluate long-term results of reresections after prior non-curative surgery for T2 carcinomas. METHODS: Retrospective study from January 1985 to July 2001. Twelve out of 14 pT2 cancers were found postoperatively. All but one underwent reresection: these 11 patients are the basis of our series. RESULTS: The in-hospital mortality rate was 0%. Overall 5-year survival was 63.5% with a median survival of 25 months. Median and 5-year survival of the eight cases without preoperative signs of disease (Group A) were 46.7 months and 100%. These results were significantly better than those obtained in the subset (Group B: three cases) with preoperative signs of disease (P = 0.01): all these patients died of recurrence within 25 months from the reoperation. Mean time between cholecystectomy and reresection was 2.2 and 11.3 months in the Group A and B (P = 0.01), respectively. CONCLUSIONS: T2 cancers discovered incidentally after simple cholecystectomy should be reoperated on as soon as possible, as the appearance, before reoperation, of a recurrence is significantly related to a dismal prognosis.