Short- and Long-term Surgical Results of Extended Surgery for Widespread Gallbladder Carcinoma.

IF 1.8 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

In vivo Pub Date : 2025-03-01 DOI:10.21873/invivo.13907

Takehiro Noji, Shintaro Takeuchi, Masataka Wada, Kimitaka Tanaka, Aya Matsui, Yoshitsugu Nakanishi, Toshimichi Asano, Toru Nakamura, Yasuyuki Kawamoto, Satoshi Hirano

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引用次数: 0

Abstract

Background/aim: Hepatectomy with extrahepatic bile duct resection (Hx+EBDR), pancreaticoduodenectomy (PD), and occasionally hepatopancreaticoduodenectomy (HPD) are required for the treatment of advanced gallbladder cancer (GBC). This study aimed to clarify the clinical value of these extended surgeries for GBC.

Patients and methods: We retrospectively reviewed the medical records of patients who underwent curative resection (Surg-G, n=59), and their survival rates were compared with those of patients with unresectable GBC who underwent chemotherapy (CTx-G, n=63).

Results: We performed PD (n=15), Hx+EBDR (n=37), and HPD (n=7). The postoperative complication and death rates were as follows: PD, 40% and 7%, respectively; Hx+EBDR, 89% and 14%, respectively; and HPD, 57% and 0%, respectively. Concomitant vascular resection (VR) was required in 61% of the patients. The 5-year overall survival rate and median survival time (MST) for Surg-G were 25.1% and 26 months, respectively, whereas those for CTx-G were 4.6% and 14.4 months, respectively. There were no significant differences between the surgical procedures. Patients who underwent VR had similar prognoses (5-year overall survival rate and MST: 14.5% and 22.3 months, respectively) as the patients in CTx-G.

Conclusion: Although extended surgery may be considered for patients with GBC, careful patient selection and new therapeutic strategies are required, especially for those requiring VR.

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背景/目的：治疗晚期胆囊癌（GBC）需要进行肝切除加肝外胆管切除术（Hx+EBDR）、胰十二指肠切除术（PD），有时还需要进行肝胰十二指肠切除术（HPD）。本研究旨在明确这些扩大手术对 GBC 的临床价值：我们回顾性地查看了接受根治性切除术（Surg-G，n=59）患者的病历，并将他们的生存率与接受化疗的不可切除 GBC 患者（CTx-G，n=63）的生存率进行了比较：我们进行了PD（15人）、Hx+EBDR（37人）和HPD（7人）手术。术后并发症和死亡率如下：PD分别为40%和7%；Hx+EBDR分别为89%和14%；HPD分别为57%和0%。61%的患者需要同时进行血管切除术（VR）。手术-G的5年总生存率和中位生存时间（MST）分别为25.1%和26个月，而CTx-G分别为4.6%和14.4个月。两种手术方法之间没有明显差异。接受VR的患者与CTx-G患者的预后相似（5年总生存率和MST分别为14.5%和22.3个月）：结论：尽管GBC患者可以考虑扩大手术范围，但仍需要谨慎选择患者并采取新的治疗策略，尤其是对于需要进行VR的患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

In vivo 医学-医学：研究与实验

CiteScore

4.20

自引率

4.30%

发文量

330

审稿时长

3-8 weeks

期刊介绍： IN VIVO is an international peer-reviewed journal designed to bring together original high quality works and reviews on experimental and clinical biomedical research within the frames of physiology, pathology and disease management. The topics of IN VIVO include: 1. Experimental development and application of new diagnostic and therapeutic procedures; 2. Pharmacological and toxicological evaluation of new drugs, drug combinations and drug delivery systems; 3. Clinical trials; 4. Development and characterization of models of biomedical research; 5. Cancer diagnosis and treatment; 6. Immunotherapy and vaccines; 7. Radiotherapy, Imaging; 8. Tissue engineering, Regenerative medicine; 9. Carcinogenesis.