title: Actual recurrence patterns and risk factors influencing recurrence after curative resection with stage II gallbladder carcinoma.
abstract: 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.
authors.affiliation: Department of Surgery, Yongdong Severance Hospital, Yonsei University College of Medicine, 146-92, Dogok-dong, Kangnam-Gu, Seoul 135-720, Korea.
authors.forename: Joon Seong
authors.initials: JS
authors.lastname: Park
authors.forename: Dong Sup
authors.initials: DS
authors.lastname: Yoon
authors.forename: Kyung Sik
authors.initials: KS
authors.lastname: Kim
authors.forename: Jin Sub
authors.initials: JS
authors.lastname: Choi
authors.forename: Woo Jung
authors.initials: WJ
authors.lastname: Lee
authors.forename: Hoon Sang
authors.initials: HS
authors.lastname: Chi
authors.forename: Byong Ro
authors.initials: BR
authors.lastname: Kim
mesh_terms: D002277:Carcinoma / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D002763:Cholecystectomy / Q000145:classification; D017081:Cholecystectomy, Laparoscopic; D003082:Colectomy; D003135:Common Bile Duct / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D016577:Pancreaticoduodenectomy; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors