Keywords
Gallbladder cancer; Surgery; Chemo radiation; Bile duct
Abstract
Introduction: Gallbladder carcinoma is the most frequent tumor of the bile system and has a poor prognosis. The main proportion of tumors diagnosed coincidentally after gallbladder removal for various reasons. In these cases, an incomplete removal of the tumors occurs frequently. The adequate treatment of these patients is still under discussion. We present our experience with different procedures.
Patients and Methods: Between 1990 and 2015, we identified 20 patients which were presented at our University Hospital after incomplete removal of gallbladder cancer (R1, R2, RX) as incidental findings after cholecystectomy. The prospectively collected data including surgery, adjuvant treatment, histopathological examinations of the specimens and follow-up data were analyzed retrospectively.
Results: The median age of patients was 72 years (range 47-89 years), 90 % (18/20) were female. The median follow-up period was 10 months (range 0-109 months). The median survival of all patients was 11 months (95 % confidence interval: 5-17 months). The median survival of patients who received staged surgery and chemo radiation after incomplete gallbladder removal was significantly increased (median 32 months; range 4-109 months) vs. patients who received chemo radiation without surgery (median 13 months; range 8-51 months) or chemotherapy alone (median 2.5 months (range 0-40 months)) (p = 0.005).
Discussion: There is no standardized treatment for residual tumor after incomplete gallbladder cancer resection. Our data demonstrate that staged surgery with prior chemo radiation may improve patient´s outcome. Surgery can be performed with low morbidity and mortality.
Citation
Daniels M, Brunner M, Semrau S, Grützmann R and Croner RS. Staged Surgery Combined with Chemo Radiation Improves Outcome after Incomplete Removal of Gallbladder Cancer. J Surg Oncol Clin Res. 2018; 2(1): 1007