title: Inapparent carcinoma of the gallbladder. An appraisal of a radical second operation after simple cholecystectomy.
abstract: This study was designed to investigate issues concerning "inapparent carcinoma" of the gallbladder and the effectiveness of a radical second operation in the treatment of inapparent carcinoma. Ninety-eight patients with inapparent carcinoma were analyzed according to the "pT" category of TNM (tumor, nodes, and metastases) classification. Eighty patients underwent cholecystectomy alone, and 14 patients had a subsequent radical operation. After cholecystectomy alone it was found that (1) Patients with pT1 cancer had a 5-year survival rate (5ysr) of 100%; (2) In patients with pT2, 5ysr was 40%; and (3) Patients with pT3 showed 5ysr of 0%. Results of a radical second operation showed that (1) Patients with pT2 cancer showed a 5ysr of 90%, significantly better (p less than 0.05) than pT2 treated with cholecystectomy alone; (2) There was a prolongation of survival in patients with pT3 or pT4. It was concluded that a radical second operation should be carried out for pT2 or more advanced inapparent carcinoma, whereas follow-up without a second operation is recommended for pT1 cancer without positive margin.
authors.affiliation: Department of Surgery, Niigata University, School of Medicine, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Shirai
authors.forename: K
authors.initials: K
authors.lastname: Yoshida
authors.forename: K
authors.initials: K
authors.lastname: Tsukada
authors.forename: T
authors.initials: T
authors.lastname: Muto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts / Q000601:surgery; D002277:Carcinoma / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D002763:Cholecystectomy / Q000379:methods*; D003549:Cystic Duct / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005704:Gallbladder / Q000601:surgery; D005706:Gallbladder Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D012086:Reoperation; D015996:Survival Rate