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KMID : 0870420080120030173
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
2008 Volume.12 No. 3 p.173 ~ p.179
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Clinical Features and Prognostic Factors Influencing Long-term Survival in pT2 Gallbladder Carcinoma Patients
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Kang Shin-Yong
Kim Sang-Geol
Yeun Young-Guk
Kim Sung-Hi
Kim Dong-Sun
Hwang Yoon-Jin
Lee Seon-Ki
Kim Jong-Yeol
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Abstract
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Purpose: The prognosis of gallbladder carcinoma is unfavorable, and the depth of invasion, the T-factor, is the most important prognostic factor. T2 tumors are not easily diagnosed preoperatively, and they have unpredictable behavior. In this study, we reviewed the clinicopathologic features of pT2 gallbladder carcinoma and identified prognostic factors.
Methods: We enrolled 64 pT2 gallbladder carcinoma patients who underwent surgery in Kyungpook National University Hospital between January 1992 and July 2006. The clinicopathologic features were retrospectively reviewed, and univariate and multivariate analyses were performed using the Kaplan-Meyer method and Cox regression hazard model to
identify factors influencing long-term survival.
Results: Twenty-one patients (32.8%) were asymptomatic, with seven tumors (10.9%) found incidentally. The gallbladder body was the most commonly involved site (45.3%, 29/64). Although CA19-9 was not sensitive, it was helpful for predicting recurrence. The 5-year diseasespecific survival rate in R0 resection was 75.9%, whereas no patients in the R1 or R2 resection groups survived more than 18 months.ANone of the clinicopathologic factors was prognostic. The unfavorable prognostic effect associated with lymph node involvement highlights the importance of complete lymph node dissection. Partial liver resection favorably affected survival, but not to a statistically significant degree.
Conclusion: Absence of symptoms and specific imaging findings in patients with considerable pT2 gallbladder carcinoma warrants high disease suspicion, and every effort should be taken to achieve R0 resection with extensive lymph node dissection, since it may improve long-term survival in pT2 carcinoma patients.
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KEYWORD
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pT2, Gallbladder carcinoma, Prognostic factor
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