演題

IS-3-5

Long-term outcomes of radical resection for advanced gallbladder carcinoma

[演者] 若井 俊文:1
[著者] 坂田 純:1, 岡部 康之:1, 廣瀬 雄己:1, 相馬 大輝:1, 油座 築:1, 須藤 翔:1, 堅田 朋大:1, 森本 悠太:1, 三浦 宏平:1, 佐藤 良平:1, 滝沢 一泰:1, 永橋 昌幸:1, 亀山 仁史:1, 小林 隆:1, 皆川 昌広:1, 小杉 伸一:1, 小山 諭:1
1:新潟大学消化器・一般外科

Background: This study aimed to clarify long-term outcomes of radical resection for advanced gallbladder carcinoma.
Methods: A retrospective analysis was conducted of 159 patients with advanced gallbladder carcinoma. Resection procedures included extended radical cholecystectomy (n=92) and more extensive resection (n=67). The primary tumor was classified as pathologic Stage (pStage) II in 42 patients, Stage III in 60, and Stage IV in 57. Adjuvant chemotherapy was performed for 58 patients (5FU in 48 patients and GEM in 10). The median follow-up time was 144 months.
Results: Cumulative 5-year survival rates were 91%, 49%, and 23% in patients with pStage II, III, and IV, respectively (P<0.001). Cumulative 5-year survival rate was significantly better in 58 patients with adjuvant chemotherapy than in 101 patients without (66% versus 40%, P=0.001). Adjuvant chemotherapy (P=0.001) and pStage (P=0.024) were independent prognostic factors. Among patients with pStage II/III, cumulative 5-year survival rate was significantly better in 76 patients who underwent extended radical cholecystectomy than in 26 patients who underwent more extensive resection (76% versus 39%, P<0.001; Fig. 1). Among patients with pStage III/IV, cumulative 5-year survival rate was significantly better in 40 patients with adjuvant chemotherapy than in 77 patients without (53% versus 27%, P=0.004; Fig. 2), whereas the efficacy of adjuvant chemotherapy was not observed in patients with pStage II (P=0.537).
Conclusions: Extended radical cholecystectomy provides survival benefit for patients with pStage II/III tumors. Patients with pStage III/IV tumors appear to be candidates for adjuvant chemotherapy.
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