Actual recurrence patterns and risk factors influencing recurrence after curative resection with stage II gallbladder carcinoma
Actual recurrence patterns and risk factors influencing recurrence after curative resection with stage II gallbladder carcinoma
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DOI：
10.1007/s11605-007-0109-z
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发表时间：
2007-05-01
影响因子：
3.2
通讯作者：
Kim, Byong Ro
中科院分区：
文献类型：
--
作者：
Park, Joon Seong;Yoon, Dong Sup;Kim, Byong Ro
尽管成像技术的进步，大多数患者只能在晚期诊断：预后非常差。近年来的研究表明，进展期胆囊癌行积极的根治性切除术，预后良好。然而，晚期胆囊癌根治性切除术后复发仍是主要问题。本研究的目的是确定II期胆囊癌根治性切除术后复发的模式和危险因素。1991年1月至2003年12月，100例患者在延世大学医学中心接受胆囊癌根治性切除术。其中，77例根据国际抗癌联盟分类（第六版）被定义为II期胆囊癌。在77名患者中，对67名患者进行了肿瘤复发预测因素的审查。67例患者中，38例（56.7%）复发。平均复发时间为21.1 ± 26.7个月，最常见的部位是腹腔内器官：肝脏和下腔静脉淋巴结。浸润性和低分化类型被认为是II期胆囊癌根治性切除术后复发的独立预后因素，这表明有必要进行大型多中心随机对照试验来阐明辅助化疗在这些患者中的作用。
Despite the advances in imaging techniques, most patients can only be diagnosed at advanced stage: The prognosis is very poor. Recent studies showed that aggressive radical resection for advanced gallbladder carcinoma can give an acceptable prognosis. However, recurrence frequently remains the main problem after curative resection of advanced gallbladder carcinoma. The aim of this study was to identify the patterns and risk factors of recurrence after curative resection for stage II gallbladder carcinoma. Between January 1991 and December 2003, 100 patients received radical curative resection for gallbladder carcinoma at Yonsei University Medical Center. Of these, 77 were defined with stage II gallbladder carcinoma according to the Union Internationale Contre Le Cancer classification (sixth edition). Of the 77 patients, 67 were reviewed for the predictors of tumor recurrence. Among the 67 patients, 38 (56.7%) suffered a recurrence. The mean length to the recurrence was 21.1 +/- 26.7 months, with the most common site being the intraabdominal organs: liver and aortocaval lymph nodes. Infiltrating and poorly differentiated types were identified as independent prognostic factors of recurrence after curative resection for stage II gallbladder carcinoma and it suggests that large multicenter randomized control trials are necessary to clarify the role of adjuvant chemotherapy in these patients.