StageⅡ 담낭암의 근치적 절제술 후 재발 양상과 재발 위험 요소

Abstract

Purpose: Despite the advances in hepatobiliary imaging techniques, most patients with a gall bladder carcinoma are diagnosed at an advanced stage, with a very poor prognosis. Recent studies have shown that aggressive radical resection for an advanced stage gallbladder carcinoma can give an acceptable prognosis. However, recurrence frequently remains the main problem after a curative resection of an advanced stage gallbladder carcinoma. The aim of this study was to identify the patterns of recurrence and factors affecting recurrence after a curative resection for a stage II gallbladder carcinoma. Methods: Between January 1991 and December 2003, 100 patients received a radical curative resection for a gallbladder carcinoma at the Yonsei University Medical Center. Of these, 77 were defined with a stage II gallbladder carcinoma according to the UICC classification (6th edition). Of the 77 patients, 67 were reviewed, and the predictors of tumor recurrence analyzed. Results: Among the 67 patients, 38 (56.7%) suffered a recurrence. The mean length to the recurrence was 21.1 months (± 26.7 months), with the most common site being the intra- abdominal organs: liver and aortocaval lymph nodes. Infiltrating and poorly differentiated types were identified as independent prognostic factors of a recurrence after a curative resection for a stage II gallbladder carcinoma. Conclusion: In conclusion, as a higher probability of recurrence is anticipated in cases of infiltrating and poorly differentiated types of tumor support the need for the developmentof an effective postoperative adjuvant modality for this high risk group of patients.