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Katsuyoshi Hatakeyama - One of the best experts on this subject based on the ideXlab platform.
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number of positive lymph nodes independently determines the prognosis after resection in patients with Gallbladder Carcinoma
Annals of Surgical Oncology, 2010Co-Authors: Jun Sakata, Yoshio Shirai, Toshifumi Wakai, Yoichi Ajioka, Katsuyoshi HatakeyamaAbstract:This study was designed to compare the prognostic power of the location of positive lymph nodes with that of the number of positive lymph nodes in Gallbladder Carcinoma. A retrospective analysis was conducted of 116 consecutive patients who underwent an R0 radical resection for Gallbladder Carcinoma. A total of 2,406 lymph nodes taken from the patients were examined histologically. The location of positive regional nodes was classified according to the Japanese staging system. The number of positive regional nodes was recorded for each patient. Nodal disease was found in 49 patients, of whom 19 survived for more than 5 years after resection. Univariate analysis revealed that both the location (P < 0.0001) and the number (P < 0.0001) of positive nodes were significant prognostic factors. Multivariate analysis revealed that the number of positive nodes was an independent prognostic factor (P < 0.001), whereas the location of positive nodes failed to remain as an independent variable. The cumulative 5-year survival rates were 81% for patients without regional nodal disease, 62% for patients with a single positive node, 43% for patients with 2–3 positive nodes, and 15% for patients with ≥4 positive nodes (P < 0.0001). The number, not the location, of positive lymph nodes independently determines the prognosis after resection in Gallbladder Carcinoma. No nodal disease or a single positive node indicates a favorable outcome after resection, whereas radical lymph node dissection is effective for selected patients with multiple positive nodes, provided that an R0 resection is feasible.
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mode of hepatic spread from Gallbladder Carcinoma an immunohistochemical analysis of 42 hepatectomized specimens
The American Journal of Surgical Pathology, 2010Co-Authors: Toshifumi Wakai, Yoshio Shirai, Jun Sakata, Masayuki Nagahashi, Yoichi Ajioka, Katsuyoshi HatakeyamaAbstract:This study aimed to clarify the mode of hepatic spread from Gallbladder Carcinoma and to elucidate its prognostic value. A retrospective analysis was conducted of 42 consecutive patients who underwent resection for Gallbladder Carcinoma with hepatic involvement verified histologically. The mode of hepatic spread was classified into 3 patterns: direct invasion through the Gallbladder bed, portal tract invasion, and hepatic metastatic nodules. Intrahepatic lymphatic invasion was declared when either single tumor cells or cell clusters were clearly visible within vessels that showed immunoreactivity to the D2-40 monoclonal antibody. Seven, 24, and 11 patients had direct invasion alone, portal tract invasion with (22 patients) or without (2 patients) direct invasion, and hepatic metastatic nodules, respectively. Of the 24 patients with portal tract invasion, 14 had intrahepatic lymphatic invasion, 8 had neither intrahepatic lymphatic nor venous invasion, and 2 had both intrahepatic lymphatic and venous invasion. To date, 4 patients with direct invasion alone and 4 patients with portal tract invasion survived more than 5 years after resection, whereas all the patients with hepatic metastatic nodules died within 11 months after resection, irrespective of the type of hepatectomy. The mode of hepatic spread (P<0.001) was a strong independent prognostic factor. Direct liver invasion and portal tract invasion, which features intrahepatic lymphatic invasion, are the main modes of hepatic spread from resectable Gallbladder Carcinoma. The mode of hepatic spread independently predicts long-term survival after resection for patients with Gallbladder Carcinoma. Hepatic metastatic nodules indicate a dismal outcome after resection.
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high risk of Gallbladder Carcinoma in elderly patients with segmental adenomyomatosis of the Gallbladder
Journal of Experimental & Clinical Cancer Research, 2004Co-Authors: N Nabatame, Takashi Wakai, Yoshio Shirai, Naoyuki Yokoyama, Atsushi Nishimura, Katsuyoshi HatakeyamaAbstract:: The clinical significance of adenomyomatosis of the Gallbladder remains unclear. This study aimed to clarify the relationship between segmental adenomyomatosis and Gallbladder Carcinoma, and to elucidate the histogenesis of Gallbladder Carcinoma associated with segmental adenomyomatosis. A total of 4,560 consecutive patients underwent cholecystectomy. The specimens were examined grossly and histologically. Adenomyomatosis of the Gallbladder was divided into segmental, fundal, and diffuse types. Sixty noncancerous Gallbladders with segmental adenomyomatosis were examined for epithelial metaplasia. The incidence of Gallbladder Carcinoma was higher in patients with segmental adenomyomatosis (22/334, 6.6%) than in those without (181/4226, 4.3%; P=0.049). This difference was more marked among patients equal to or older than 60 years of age (15/96,15.6% versus 147/2407, 6.1%, respectively; P<0.001). The other types of adenomyomatosis did not show any significant increases in the incidence of Gallbladder Carcinoma. In all 22 patients with both segmental adenomyomatosis and Carcinoma, the tumors developed only in the fundal mucosa. Epithelial metaplasia was more marked in the fundal mucosa of segmental adenomyomatosis than in the neck mucosa (P=0.003). Segmental adenomyomatosis is a high-risk condition for Gallbladder Carcinoma, especially in elderly patients. Epithelial metaplasia appears to be related to increased carcinogenesis in the fundal mucosa of segmental adenomyomatosis.
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depth of subserosal invasion predicts long term survival after resection in patients with t2 Gallbladder Carcinoma
Annals of Surgical Oncology, 2003Co-Authors: Toshifumi Wakai, Yoshio Shirai, Naoyuki Yokoyama, Hidenobu Watanabe, Yoichi Ajioka, Katsuyoshi HatakeyamaAbstract:Background: This study aimed to identify a subgroup of patients with inapparent T2 Gallbladder Carcinoma who may be best suited for radical second resection.
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radical second resection provides survival benefit for patients with t2 Gallbladder Carcinoma first discovered after laparoscopic cholecystectomy
World Journal of Surgery, 2002Co-Authors: Toshifumi Wakai, Yoshio Shirai, Katsuyoshi HatakeyamaAbstract:Port site recurrence or peritoneal seeding is a fatal complication following laparoscopic cholecystectomy for Gallbladder Carcinoma. The aims of this retrospective analysis were to determine the association of Gallbladder perforation during laparoscopic cholecystectomy with port site/peritoneal recurrence and to determine the role of radical second resection in the management of Gallbladder Carcinoma first diagnosed after laparoscopic cholecystectomy. A total of 28 patients undergoing laparoscopic cholecystectomy for Gallbladder Carcinoma were analyzed, of whom 10 had a radical second resection. Five patients had recurrences; port site/peritoneum recurrence in 3 and distant metastasis in 2. The incidence of port site/peritoneal recurrence was higher in patients with Gallbladder perforation (3/7, 43%) than in those without (0/21, 0%) (p = 0.011). The outcome after laparoscopic cholecystectomy was worse in 7 patients with Gallbladder perforation (cumulative 5-year survival of 43%) than in those without (cumulative 5-year survival of 100%) (p < 0.001). Among 13 patients with a pT2 tumor, the outcome after radical second resection (cumulative 5-year survival of 100%) was better than that after laparoscopic cholecystectomy alone (cumulative 5-year survival of 50%) (p = 0.039), although there was no survival benefit of radical second resection in the 15 patients with a pT1 tumor (p = 0.65). In conclusion, Gallbladder perforation during laparoscopic cholecystectomy is associated with port site/peritoneal recurrence and worse patient survival. Radical second resection may be beneficial for patients with pT2 Gallbladder Carcinoma first discovered after laparoscopic cholecystectomy.
Yoshio Shirai - One of the best experts on this subject based on the ideXlab platform.
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number of positive lymph nodes independently determines the prognosis after resection in patients with Gallbladder Carcinoma
Annals of Surgical Oncology, 2010Co-Authors: Jun Sakata, Yoshio Shirai, Toshifumi Wakai, Yoichi Ajioka, Katsuyoshi HatakeyamaAbstract:This study was designed to compare the prognostic power of the location of positive lymph nodes with that of the number of positive lymph nodes in Gallbladder Carcinoma. A retrospective analysis was conducted of 116 consecutive patients who underwent an R0 radical resection for Gallbladder Carcinoma. A total of 2,406 lymph nodes taken from the patients were examined histologically. The location of positive regional nodes was classified according to the Japanese staging system. The number of positive regional nodes was recorded for each patient. Nodal disease was found in 49 patients, of whom 19 survived for more than 5 years after resection. Univariate analysis revealed that both the location (P < 0.0001) and the number (P < 0.0001) of positive nodes were significant prognostic factors. Multivariate analysis revealed that the number of positive nodes was an independent prognostic factor (P < 0.001), whereas the location of positive nodes failed to remain as an independent variable. The cumulative 5-year survival rates were 81% for patients without regional nodal disease, 62% for patients with a single positive node, 43% for patients with 2–3 positive nodes, and 15% for patients with ≥4 positive nodes (P < 0.0001). The number, not the location, of positive lymph nodes independently determines the prognosis after resection in Gallbladder Carcinoma. No nodal disease or a single positive node indicates a favorable outcome after resection, whereas radical lymph node dissection is effective for selected patients with multiple positive nodes, provided that an R0 resection is feasible.
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mode of hepatic spread from Gallbladder Carcinoma an immunohistochemical analysis of 42 hepatectomized specimens
The American Journal of Surgical Pathology, 2010Co-Authors: Toshifumi Wakai, Yoshio Shirai, Jun Sakata, Masayuki Nagahashi, Yoichi Ajioka, Katsuyoshi HatakeyamaAbstract:This study aimed to clarify the mode of hepatic spread from Gallbladder Carcinoma and to elucidate its prognostic value. A retrospective analysis was conducted of 42 consecutive patients who underwent resection for Gallbladder Carcinoma with hepatic involvement verified histologically. The mode of hepatic spread was classified into 3 patterns: direct invasion through the Gallbladder bed, portal tract invasion, and hepatic metastatic nodules. Intrahepatic lymphatic invasion was declared when either single tumor cells or cell clusters were clearly visible within vessels that showed immunoreactivity to the D2-40 monoclonal antibody. Seven, 24, and 11 patients had direct invasion alone, portal tract invasion with (22 patients) or without (2 patients) direct invasion, and hepatic metastatic nodules, respectively. Of the 24 patients with portal tract invasion, 14 had intrahepatic lymphatic invasion, 8 had neither intrahepatic lymphatic nor venous invasion, and 2 had both intrahepatic lymphatic and venous invasion. To date, 4 patients with direct invasion alone and 4 patients with portal tract invasion survived more than 5 years after resection, whereas all the patients with hepatic metastatic nodules died within 11 months after resection, irrespective of the type of hepatectomy. The mode of hepatic spread (P<0.001) was a strong independent prognostic factor. Direct liver invasion and portal tract invasion, which features intrahepatic lymphatic invasion, are the main modes of hepatic spread from resectable Gallbladder Carcinoma. The mode of hepatic spread independently predicts long-term survival after resection for patients with Gallbladder Carcinoma. Hepatic metastatic nodules indicate a dismal outcome after resection.
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high risk of Gallbladder Carcinoma in elderly patients with segmental adenomyomatosis of the Gallbladder
Journal of Experimental & Clinical Cancer Research, 2004Co-Authors: N Nabatame, Takashi Wakai, Yoshio Shirai, Naoyuki Yokoyama, Atsushi Nishimura, Katsuyoshi HatakeyamaAbstract:: The clinical significance of adenomyomatosis of the Gallbladder remains unclear. This study aimed to clarify the relationship between segmental adenomyomatosis and Gallbladder Carcinoma, and to elucidate the histogenesis of Gallbladder Carcinoma associated with segmental adenomyomatosis. A total of 4,560 consecutive patients underwent cholecystectomy. The specimens were examined grossly and histologically. Adenomyomatosis of the Gallbladder was divided into segmental, fundal, and diffuse types. Sixty noncancerous Gallbladders with segmental adenomyomatosis were examined for epithelial metaplasia. The incidence of Gallbladder Carcinoma was higher in patients with segmental adenomyomatosis (22/334, 6.6%) than in those without (181/4226, 4.3%; P=0.049). This difference was more marked among patients equal to or older than 60 years of age (15/96,15.6% versus 147/2407, 6.1%, respectively; P<0.001). The other types of adenomyomatosis did not show any significant increases in the incidence of Gallbladder Carcinoma. In all 22 patients with both segmental adenomyomatosis and Carcinoma, the tumors developed only in the fundal mucosa. Epithelial metaplasia was more marked in the fundal mucosa of segmental adenomyomatosis than in the neck mucosa (P=0.003). Segmental adenomyomatosis is a high-risk condition for Gallbladder Carcinoma, especially in elderly patients. Epithelial metaplasia appears to be related to increased carcinogenesis in the fundal mucosa of segmental adenomyomatosis.
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depth of subserosal invasion predicts long term survival after resection in patients with t2 Gallbladder Carcinoma
Annals of Surgical Oncology, 2003Co-Authors: Toshifumi Wakai, Yoshio Shirai, Naoyuki Yokoyama, Hidenobu Watanabe, Yoichi Ajioka, Katsuyoshi HatakeyamaAbstract:Background: This study aimed to identify a subgroup of patients with inapparent T2 Gallbladder Carcinoma who may be best suited for radical second resection.
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radical second resection provides survival benefit for patients with t2 Gallbladder Carcinoma first discovered after laparoscopic cholecystectomy
World Journal of Surgery, 2002Co-Authors: Toshifumi Wakai, Yoshio Shirai, Katsuyoshi HatakeyamaAbstract:Port site recurrence or peritoneal seeding is a fatal complication following laparoscopic cholecystectomy for Gallbladder Carcinoma. The aims of this retrospective analysis were to determine the association of Gallbladder perforation during laparoscopic cholecystectomy with port site/peritoneal recurrence and to determine the role of radical second resection in the management of Gallbladder Carcinoma first diagnosed after laparoscopic cholecystectomy. A total of 28 patients undergoing laparoscopic cholecystectomy for Gallbladder Carcinoma were analyzed, of whom 10 had a radical second resection. Five patients had recurrences; port site/peritoneum recurrence in 3 and distant metastasis in 2. The incidence of port site/peritoneal recurrence was higher in patients with Gallbladder perforation (3/7, 43%) than in those without (0/21, 0%) (p = 0.011). The outcome after laparoscopic cholecystectomy was worse in 7 patients with Gallbladder perforation (cumulative 5-year survival of 43%) than in those without (cumulative 5-year survival of 100%) (p < 0.001). Among 13 patients with a pT2 tumor, the outcome after radical second resection (cumulative 5-year survival of 100%) was better than that after laparoscopic cholecystectomy alone (cumulative 5-year survival of 50%) (p = 0.039), although there was no survival benefit of radical second resection in the 15 patients with a pT1 tumor (p = 0.65). In conclusion, Gallbladder perforation during laparoscopic cholecystectomy is associated with port site/peritoneal recurrence and worse patient survival. Radical second resection may be beneficial for patients with pT2 Gallbladder Carcinoma first discovered after laparoscopic cholecystectomy.
Yingbin Liu - One of the best experts on this subject based on the ideXlab platform.
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Curcumin induces apoptosis in Gallbladder Carcinoma cell line GBC-SD cells.
Cancer cell international, 2013Co-Authors: Tian-yu Liu, Zhujun Tan, Lin Jiang, Yang Cao, Yingbin LiuAbstract:Background Gallbladder Carcinoma is a malignant tumor with a very low 5-year survival rate because of the difficulty with its early diagnosis and the very poor prognosis of the advanced cancer state. The aims of this study were to determine whether curcumin could induce the apoptosis of a Gallbladder Carcinoma cell line, GBC-SD, and to clarify its related mechanism.
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effects of matrine on proliferation and apoptosis in Gallbladder Carcinoma cells gbc sd
Phytotherapy Research, 2012Co-Authors: Zhiping Zhang, Yingbin Liu, Xuefeng Wang, Jianwei Wang, Yong Wang, Xiaozhou Fei, Jie Zhang, Ping DongAbstract:Although matrine, a primary active component of dried Sophora flavescens root (ku shen), is known to induce apoptosis in a variety of tumor cells in vitro, the molecular mechanism of such apoptosis remains elusive. This analysis of the cell cycle and apoptosis in matrine-treated human Gallbladder Carcinoma cells (GBC-SD) showed that matrine can indeed inhibit cell proliferation and induce G1 cell cycle arrest and apoptosis in a dose- and time-dependent manner. An additional western blot analysis of matrine-treated cells also showed caspase-3 and Bcl-2 activation, as well as cyclinE down-regulation. Overall, the results indicate that matrine perturbs Gallbladder cancer cell progression during the G1 phase by down-regulating cyclinE and induces apoptosis by decreasing the expression of the antiapoptotic protein Bcl-2 and increasing expression of the proapoptotic protein Bax.
Toshifumi Wakai - One of the best experts on this subject based on the ideXlab platform.
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number of positive lymph nodes independently determines the prognosis after resection in patients with Gallbladder Carcinoma
Annals of Surgical Oncology, 2010Co-Authors: Jun Sakata, Yoshio Shirai, Toshifumi Wakai, Yoichi Ajioka, Katsuyoshi HatakeyamaAbstract:This study was designed to compare the prognostic power of the location of positive lymph nodes with that of the number of positive lymph nodes in Gallbladder Carcinoma. A retrospective analysis was conducted of 116 consecutive patients who underwent an R0 radical resection for Gallbladder Carcinoma. A total of 2,406 lymph nodes taken from the patients were examined histologically. The location of positive regional nodes was classified according to the Japanese staging system. The number of positive regional nodes was recorded for each patient. Nodal disease was found in 49 patients, of whom 19 survived for more than 5 years after resection. Univariate analysis revealed that both the location (P < 0.0001) and the number (P < 0.0001) of positive nodes were significant prognostic factors. Multivariate analysis revealed that the number of positive nodes was an independent prognostic factor (P < 0.001), whereas the location of positive nodes failed to remain as an independent variable. The cumulative 5-year survival rates were 81% for patients without regional nodal disease, 62% for patients with a single positive node, 43% for patients with 2–3 positive nodes, and 15% for patients with ≥4 positive nodes (P < 0.0001). The number, not the location, of positive lymph nodes independently determines the prognosis after resection in Gallbladder Carcinoma. No nodal disease or a single positive node indicates a favorable outcome after resection, whereas radical lymph node dissection is effective for selected patients with multiple positive nodes, provided that an R0 resection is feasible.
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mode of hepatic spread from Gallbladder Carcinoma an immunohistochemical analysis of 42 hepatectomized specimens
The American Journal of Surgical Pathology, 2010Co-Authors: Toshifumi Wakai, Yoshio Shirai, Jun Sakata, Masayuki Nagahashi, Yoichi Ajioka, Katsuyoshi HatakeyamaAbstract:This study aimed to clarify the mode of hepatic spread from Gallbladder Carcinoma and to elucidate its prognostic value. A retrospective analysis was conducted of 42 consecutive patients who underwent resection for Gallbladder Carcinoma with hepatic involvement verified histologically. The mode of hepatic spread was classified into 3 patterns: direct invasion through the Gallbladder bed, portal tract invasion, and hepatic metastatic nodules. Intrahepatic lymphatic invasion was declared when either single tumor cells or cell clusters were clearly visible within vessels that showed immunoreactivity to the D2-40 monoclonal antibody. Seven, 24, and 11 patients had direct invasion alone, portal tract invasion with (22 patients) or without (2 patients) direct invasion, and hepatic metastatic nodules, respectively. Of the 24 patients with portal tract invasion, 14 had intrahepatic lymphatic invasion, 8 had neither intrahepatic lymphatic nor venous invasion, and 2 had both intrahepatic lymphatic and venous invasion. To date, 4 patients with direct invasion alone and 4 patients with portal tract invasion survived more than 5 years after resection, whereas all the patients with hepatic metastatic nodules died within 11 months after resection, irrespective of the type of hepatectomy. The mode of hepatic spread (P<0.001) was a strong independent prognostic factor. Direct liver invasion and portal tract invasion, which features intrahepatic lymphatic invasion, are the main modes of hepatic spread from resectable Gallbladder Carcinoma. The mode of hepatic spread independently predicts long-term survival after resection for patients with Gallbladder Carcinoma. Hepatic metastatic nodules indicate a dismal outcome after resection.
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depth of subserosal invasion predicts long term survival after resection in patients with t2 Gallbladder Carcinoma
Annals of Surgical Oncology, 2003Co-Authors: Toshifumi Wakai, Yoshio Shirai, Naoyuki Yokoyama, Hidenobu Watanabe, Yoichi Ajioka, Katsuyoshi HatakeyamaAbstract:Background: This study aimed to identify a subgroup of patients with inapparent T2 Gallbladder Carcinoma who may be best suited for radical second resection.
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radical second resection provides survival benefit for patients with t2 Gallbladder Carcinoma first discovered after laparoscopic cholecystectomy
World Journal of Surgery, 2002Co-Authors: Toshifumi Wakai, Yoshio Shirai, Katsuyoshi HatakeyamaAbstract:Port site recurrence or peritoneal seeding is a fatal complication following laparoscopic cholecystectomy for Gallbladder Carcinoma. The aims of this retrospective analysis were to determine the association of Gallbladder perforation during laparoscopic cholecystectomy with port site/peritoneal recurrence and to determine the role of radical second resection in the management of Gallbladder Carcinoma first diagnosed after laparoscopic cholecystectomy. A total of 28 patients undergoing laparoscopic cholecystectomy for Gallbladder Carcinoma were analyzed, of whom 10 had a radical second resection. Five patients had recurrences; port site/peritoneum recurrence in 3 and distant metastasis in 2. The incidence of port site/peritoneal recurrence was higher in patients with Gallbladder perforation (3/7, 43%) than in those without (0/21, 0%) (p = 0.011). The outcome after laparoscopic cholecystectomy was worse in 7 patients with Gallbladder perforation (cumulative 5-year survival of 43%) than in those without (cumulative 5-year survival of 100%) (p < 0.001). Among 13 patients with a pT2 tumor, the outcome after radical second resection (cumulative 5-year survival of 100%) was better than that after laparoscopic cholecystectomy alone (cumulative 5-year survival of 50%) (p = 0.039), although there was no survival benefit of radical second resection in the 15 patients with a pT1 tumor (p = 0.65). In conclusion, Gallbladder perforation during laparoscopic cholecystectomy is associated with port site/peritoneal recurrence and worse patient survival. Radical second resection may be beneficial for patients with pT2 Gallbladder Carcinoma first discovered after laparoscopic cholecystectomy.
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Early Gallbladder Carcinoma does not warrant radical resection.
British Journal of Surgery, 2001Co-Authors: Toshifumi Wakai, Yoshio Shirai, Naoyuki Yokoyama, Shigenori Nagakura, Hidenobu Watanabe, K. HatakeyamaAbstract:Background: This study was designed to address whether Gallbladder cancer invading the muscle layer (stage pT1b) is a local disease and whether radical resection is necessary. Methods: A retrospective analysis of 25 patients with pT1b Gallbladder tumours, 13 of whom underwent simple cholecystectomy and 12 radical resection with regional lymph node dissection, was performed. A total of 147 regional lymph nodes was examined for metastasis. The median follow-up time was 95 months. Results: No patient had blood vessel or perineural invasion on histology. Lymphatic vessel invasion was seen in one patient. Both overt metastasis and micrometastases were absent in all lymph nodes examined. Overall 10-year survival was 87 per cent. The outcome after simple cholecystectomy was comparable to that after radical resection (P = 0.16). Two patients who underwent radical resection died from tumour relapse in distant sites. Conclusion: Most pT1b Gallbladder Carcinomas spread only locally. Additional radical resection is not necessary when the depth of invasion of Gallbladder Carcinoma is limited to the muscle layer after simple cholecystectomy. © 2001 British Journal of Surgery Society Ltd
Hidenobu Watanabe - One of the best experts on this subject based on the ideXlab platform.
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depth of subserosal invasion predicts long term survival after resection in patients with t2 Gallbladder Carcinoma
Annals of Surgical Oncology, 2003Co-Authors: Toshifumi Wakai, Yoshio Shirai, Naoyuki Yokoyama, Hidenobu Watanabe, Yoichi Ajioka, Katsuyoshi HatakeyamaAbstract:Background: This study aimed to identify a subgroup of patients with inapparent T2 Gallbladder Carcinoma who may be best suited for radical second resection.
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Early Gallbladder Carcinoma does not warrant radical resection.
British Journal of Surgery, 2001Co-Authors: Toshifumi Wakai, Yoshio Shirai, Naoyuki Yokoyama, Shigenori Nagakura, Hidenobu Watanabe, K. HatakeyamaAbstract:Background: This study was designed to address whether Gallbladder cancer invading the muscle layer (stage pT1b) is a local disease and whether radical resection is necessary. Methods: A retrospective analysis of 25 patients with pT1b Gallbladder tumours, 13 of whom underwent simple cholecystectomy and 12 radical resection with regional lymph node dissection, was performed. A total of 147 regional lymph nodes was examined for metastasis. The median follow-up time was 95 months. Results: No patient had blood vessel or perineural invasion on histology. Lymphatic vessel invasion was seen in one patient. Both overt metastasis and micrometastases were absent in all lymph nodes examined. Overall 10-year survival was 87 per cent. The outcome after simple cholecystectomy was comparable to that after radical resection (P = 0.16). Two patients who underwent radical resection died from tumour relapse in distant sites. Conclusion: Most pT1b Gallbladder Carcinomas spread only locally. Additional radical resection is not necessary when the depth of invasion of Gallbladder Carcinoma is limited to the muscle layer after simple cholecystectomy. © 2001 British Journal of Surgery Society Ltd
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successful treatment of Gallbladder Carcinoma producing alpha fetoprotein with segmental adenomyomatosis
Journal of Hepato-biliary-pancreatic Surgery, 1996Co-Authors: Kazuhiro Tsukada, Yoshio Shirai, Hidenobu Watanabe, Hideo Kato, Isao Kurosaki, Katsuyuki Uchida, Yutaka Aoyagi, Yoshihisa Tsukada, Katsuyoshi HatakeyamaAbstract:The successful treatment of hepatoid adenoCarcinoma of the Gallbladder with elevated serum alpha-fetoprotein (1243 ng/ml) and segmental adenomyomatosis in a 58-year-old woman is described. The woman had alpha-fetoprotein (AFP)-producing Carcinoma of the Gallbladder with regional lymph node metastasis and was treated by extended radical resection and postoperative adjuvant chemotherapy. She is alive, showing normal serum AFP concentration and no recurrence, 57 months after surgery. The tumor cells were stained immunohistochemically for AFP by the peroxidase anti-peroxidase method. Serum AFP reactivity to concanavalin A and lentil lectin was similar to the pattern shown in hepatocellular Carcinoma. Only a few cases of AFP-producing Gallbladder Carcinoma have been reported and there have been no reports of long-term survivors. The combination of aggressive radical resection and chemotherapy seems to have been effective for achieving long-term survival without liver metastasis.
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radical surgery for Gallbladder Carcinoma long term results
Annals of Surgery, 1992Co-Authors: Yoshio Shirai, Keisuke Yoshida, Kazuhiro Tsukada, Terukazu Muto, Hidenobu WatanabeAbstract:The authors' objective was to evaluate the effectiveness of radical surgery with lymph node dissection for Gallbladder Carcinoma. Long-term results were analyzed in 40 patients in a 5-year study. The authors divided the 40 cases into two groups: 20 without positive nodes and 20 with positive nodes. In the group without positive nodes, one patient who underwent R1 resection died of a recurrence at 1 year 7 months. Seventeen of the 19 patients treated with R0 resection survived more than 5 years. The 5-year survival rate was 85% (17/20). In the group with positive nodes, 9 of the 13 patients treated with R0 resection survived more than 5 years, whereas the seven patients treated with R1 or R2 resection died within 5 years. The 5-year survival rate was 45% (9/20). Patients treated by R0 resection showed a 5-year survival rate of 69% (9/13). Thus we documented the favorable long-term results of radical surgery. R0 resection is a prerequisite for long-term survival. The results justify radical surgery with lymph node dissection.
