title: [Findings in surgical reinterventions for cancer of the gallbladder in patients with and without preoperative chemotherapy and radiotherapy].
abstract: BACKGROUND
  The usefulness of surgery in the treatment of gallbladder cancer has not been clearly established. The benefits of chemo and radiotherapy are similarly dubious.
  
  
  OBJECTIVE
  To report the pathological findings in patients subjected to surgical reinterventions for gallbladder cancer.
  
  
  METHODS
  We report 54 patients with gallbladder cancer that were subjected to a second surgical intervention for resection of liver segments IVb and V and lymph nodes corresponding to the liver hilar, portal, peripancreatic, celiac artery and periaortic territories. Thirteen of these patients were subjected to preoperative chemo-radiotherapy (4500 Gy and 5-fluouracil 500 mg/m2).
  
  
  RESULTS
  Lymph node metastases were found in 25 and 38%, and liver metastases in 25 and 28% of patients with or without chemo-radiotherapy respectively. The most frequent pathological findings attributed to radiation in the liver were fatty infiltration in 75% of cases, vascular transformation in 83% of cases and minimal periportal lymphocyte infiltration in 40% of cases. Lymph nodes were atrophic in 67% of cases and had foci of cortical necrosis in 46% of cases. Three cases had regional lymph node and liver metastases. Most tumor cells were viable.
  
  
  CONCLUSIONS
  No differences in the number of lymph node or liver metastases were observed between patients with and without chemo-radiotherapy. No effect of the treatment on residual tumor was observed either.
authors.affiliation: Unidad de Anatomía Patológica y Citopatología, Departamento de Cirugía, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile. Iroa@ufro.cl
authors.forename: I
authors.initials: I
authors.lastname: Roa
authors.forename: X
authors.initials: X
authors.lastname: de Aretxabala
authors.forename: J C
authors.initials: JC
authors.lastname: Araya
authors.forename: M
authors.initials: M
authors.lastname: Villaseca
authors.forename: J
authors.initials: J
authors.lastname: Roa
authors.forename: L
authors.initials: L
authors.lastname: Burgos
authors.forename: P
authors.initials: P
authors.lastname: Guzmán
mesh_terms: D017024:Chemotherapy, Adjuvant; D005260:Female; D005706:Gallbladder Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009336:Necrosis; D009361:Neoplasm Invasiveness; D012086:Reoperation