National Cancer Institute®
Last Modified: February 1, 2002
UI - 11677943
AU - Ajiki T; Kamigaki T; Hasegawa Y; Fujino Y; Suzuki Y; Takeyama Y; Ku Y;
TI - Kuroda Y Proliferating cell nuclear antigen, p53, and c-erbB-2 expression in relation to clinicopathological variables and prognosis in cancer of the ampulla of Vater.
SO - Hepatogastroenterology 2001 Sep-Oct;48(41):1266-70
AD - First Department of Surgery, Kobe University School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. firstname.lastname@example.org
BACKGROUND/AIMS: Various clinicopathological factors have been thought to influence the prognosis of ampullary cancers. Recent advances in molecular biology should provide much useful information on the prognostic factors of ampullary carcinomas. METHODOLOGY: PCNA (proliferating cell nuclear antigen), p53, and c-erbB-2 were immunohistochemically evaluated in 30 resectable ampullary carcinomas. PCNA, p53, and c-erbB-2 expression, 6 clinicopathological variables, and prognosis were studied and correlations among these factors were investigated. RESULTS: The mean PCNA-positive rate was 39.1%. The percentages of cases positive for p53 and c-erbB-2 were 53% and 23%, respectively. No correlation was seen between PCNA, p53, or c-erbB-2 expression and clinicopathological variables. The optimum cut-off of PCNA indices influencing recurrence was decided as 40% by receiver operator characteristic curves. The cumulative disease-free survival rate of patients from the > or = 40% PCNA positive rate group was significantly poorer than that of the < 40% PCNA positive rate group (P < 0.01). p53 accumulation and c-erbB-2 expression were not correlated with prognosis. Multivariate analysis revealed that the PCNA positive rate and lymph node metastasis independently contributed to survival (P < 0.05). CONCLUSIONS: PCNA expression is a useful prognostic marker; however, p53 and c-erbB-2 overexpression are not useful as biomarkers for ampullary cancers.
UI - 11677947
AU - Saetta A; Lazaris AC; Michalopoulos NV; Davaris PS
TI - Genetic alterations involved in the development of gallbladder carcinomas from Greek patients.
SO - Hepatogastroenterology 2001 Sep-Oct;48(41):1284-8
AD - Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece. email@example.com
BACKGROUND/AIMS: The genetic pathways of gallbladder cancer are not yet well defined since the contribution of genetic abnormalities clarified in other organs remains questionable. METHODOLOGY: We investigated a group of 22 gallbladder carcinomas from Greek patients with regard to p53 mutations, bax and TGF-beta RII alterations--as indicators of microsatellite instability. The findings were correlated to the presence of ras mutations, patients' clinicopathologic features and survival. PCR-SSCP analysis was performed for the detection of p53 mutations in conserved domains IV and V. RESULTS: In five tumors p53 mutations were detected; none of them was ras mutated. Although these tumors were characterized by flat morphology, low histologic grade and rather advanced stage, no statistical correlation could be determined. No indications of microsatellite instability were found. CONCLUSIONS: Ras and p53 genes do not appear to cooperate during gallbladder cancer, at least as far as the flat type of cancer is concerned. p53 alterations are likely to take part in the de novo pathway of gallbladder carcinogenesis.
UI - 11677948
AU - Bathe OF; Pacheco JT; Ossi PB; Hamilton KL; Franceschi D; Sleeman D;
TI - Levi JU; Livingstone AS Management of hilar bile duct carcinoma.
SO - Hepatogastroenterology 2001 Sep-Oct;48(41):1289-94
AD - Department of Surgery, University of Miami, Miami, Florida, USA. firstname.lastname@example.org
BACKGROUND/AIMS: Hilar cholangiocarcinoma is a rare tumor with a dismal prognosis. Because proximal bile duct cancers are uncommon, outcomes related to various therapeutic interventions are not well defined. METHODOLOGY: Between 1985 and 1997, 55 patients with bile duct cancers involving the proximal third of the extrahepatic bile ducts were seen. The management of patients with resectable and unresectable disease was retrospectively reviewed. All but four patients were followed until the time of death. RESULTS: Forty patients underwent laparotomy following preoperative assessment of extent of disease and 19 patients (35%) ultimately underwent resection with curative intent. Survival was significantly longer in patients who underwent resection (2-year survival 47% vs. 18%; P = 0.027). Of those patients whose disease was resected, 11 patients received adjuvant radiotherapy. Survival for this group was not significantly different from that seen in patients who did not receive adjuvant radiotherapy. Similarly, in patients with unresectable disease, administration of radiotherapy was not associated with an improved outcome. CONCLUSIONS: Locoregional extent of disease is the greatest problem in cases of proximal bile duct cancers. Resection provides the best hope for long-term survival, but new adjuvant strategies are needed.
UI - 11677950
AU - Kim MW; Kim WH; Wang HJ; Chung JB; Chun M
TI - The experiences of hilar skeletonization for the treatment of locally advanced proximal bile duct cancer.
SO - Hepatogastroenterology 2001 Sep-Oct;48(41):1298-301
AD - Department of Surgery, Ajou University School of Medicine San 5, Wonchon-dong, Paldal-gu, Suwon 442-749, Korea. email@example.com
BACKGROUND/AIMS: Because proximal bile duct cancer easily involves the surrounding tissue, tumor cells often remain after apparent macroscopically complete radical resection. We evaluated the effect of resective modality of these tumors on prognosis and the effect of postoperative radiotherapy on survival of patients with microscopic residual tumor following local resection in locally advanced proximal bile duct cancer. METHODOLOGY: From November, 1990 to October, 1993, 45 proximal bile duct cancer patients who received local excision were entered onto this prospective, nonrandomized study. The patients were divided into three groups after operation, 16 patients with curative resection; 15 noncurative resection; and 14 nonresection. Patients who had positive lymph nodes or microscopic cancer cells in resection margin or adjacent major vessels, were treated with postoperative external radiotherapy, 5040 cGy for 40 days. RESULTS: The overall 1-, 2-, and 5-year survival of the patients was 62.2%, 24.4%, and 15.6%, respectively. The overall mean and median survival of patients was 24.1 +/- 3.98 (mean +/- SE) months and 13 +/- 0.74 months, respectively. Survival rates between resection and nonresection showed a statistically significant difference (P < 0.05). However, survival rates between curative resection and noncurative resection with postoperative radiotherapy were not statistically significant (P > 0.05). CONCLUSIONS: The resection is the treatment of choice for locally advanced proximal bile duct cancer, if resectable and the noncurative resection followed by postoperative external radiotherapy may be beneficial to the patients with locally advanced proximal bile duct cancer.
UI - 11677994
AU - Schwarz RE; Keny H
TI - Preoperative platelet count predicts survival after resection of periampullary adenocarcinoma.
SO - Hepatogastroenterology 2001 Sep-Oct;48(41):1493-8
AD - City of Hope National Medical Center, Department of General Oncologic Surgery, Duarte, CA, USA. Roderich.Schwarz@umdnj.edu
BACKGROUND/AIMS: Thrombocytosis or thrombocytopenia have been shown to act as negative predictors of outcome for various solid tumors. No such effect is known for periampullary cancer. The preoperative peripheral blood platelet count impacts on outcome after resection of pancreatic and other periampullary adenocarcinomas. METHODOLOGY: Clinicopathologic information, treatment aspects, and outcome parameters of patients undergoing pancreatectomy at City of Hope Cancer Center were retrospectively collected and tabulated. The impact of the preoperative platelet count on postoperative recovery, disease-free survival, and overall survival was analyzed. RESULTS: Between 1988 and 1998, 65 patients underwent partial or total pancreatectomy at City of Hope Cancer Center, 49 of whom had a diagnosis of pancreatic or periampullary adenocarcinoma. There were 26 females and 23 males, with a median age of 64 years (range: 24-86). Median preoperative platelet count was 308 (x10(9)/L; range: 104 to 547). Diagnoses were pancreatic (n = 28), duodenal (n = 12), and bile duct/ampullary cancer (n = 9). Procedures included pancreatoduodenectomy (n = 42), distal pancreatectomy (n = 4), and total pancreatectomy (n = 3). Six patients underwent a splenectomy. A lower preoperative platelet count was correlated to a shortened prothrombin time (P = 0.02), and a positive resection margin (P = 0.01), but not operative blood loss or transfusion requirements. Postoperative complications and hospital stay were not affected by the platelet count. Preoperative platelets of < 300 were associated with a decreased median overall survival (13 vs. 33 months, P = 0.02) and disease-free survival (11 vs. 29 months, P = 0.02), at a median follow-up of 14 months (18 for survivors). On multivariate analysis, the platelet count remained a significant predictor of survival in addition to grade, perineural invasion, the primary tumor size, and the surgeon. CONCLUSIONS: Based on these retrospective data, a lower preoperative platelet count correlates with inferior, a higher count with superior survival outcome after resection of periampullary cancer. The mechanism is unclear, but may relate to general factors (bone-marrow suppression or hypersplenism for low platelets, systemic antitumor mediators for high platelets) or platelet-specific effects (platelet influence on tumor angiogenesis or metastatic efficiency). The preoperative thrombocyte count should be considered a parameter with potential clinical significance in prospective clinical studies of periampullary neoplasms.
UI - 11802210
AU - Caca K; Feisthammel J; Klee K; Tannapfel A; Witzigmann H; Wittekind C;
TI - Mossner J; Berr F Inactivation of the INK4a/ARF locus and p53 in sporadic extrahepatic bile duct cancers and bile tract cancer cell lines.
SO - Int J Cancer 2002 Feb 1;97(4):481-8
AD - Department of Medicine II, University of Leipzig, Leipzig, Germany. firstname.lastname@example.org
The tumor-suppressor genes p14(ARF), p16(INK4a) and Tp53 are commonly inactivated in many tumors. We investigated their role in the pathogenesis of 9 bile tract cancer cell lines and 21 primary sporadic extrahepatic bile duct carcinomas. p53 and p16 protein expression was examined by Western blot analysis and immunohistochemistry. Mutation screening of p53 was done by SSCP and direct sequencing. Inactivating mechanisms of p14 and p16 were addressed by screening for mutations, homozygous deletions, chromosomal loss of 9p21 (loss of heterozygosity [LOH] analysis) and promoter hypermethylation of the p14/p16 genes. p53 overexpression could be detected in 7 of 9 cell lines and 7 of 21 primary tumors, but mutations were found in 3 cell lines only. p16 expression was absent in all cell lines, due to homozygous deletion of the gene in 8 of 9 cell lines and hypermethylation of the p16 promoter in one cell line (CC-LP-1). p14 exon 1beta was homozygously deleted in 6 of 9 cell lines, while retained in CC-LP-1 and 2 additional lines. No p14 promoter hypermethylation could be detected. p16 expression was lost in 11 of 21 primary tumors. p16 promoter hypermethylation was present in 9 of 21 primary tumors, all with lost p16 expression. Allelic loss at 9p21 was detected in 13 of 21 primary tumors, 10 of 11 with lost p16 expression and 8 of 9 with methylated p16 promoter. No p14 promoter hypermethylation or p14/p16 mutations could be detected. Neither Tp53 nor p16 alterations showed obvious association with histopathologic or clinical characteristics. In conclusion, inactivation of the p16 gene is a frequent event in primary sporadic extrahepatic bile duct cancers, 9p21 LOH and promoter hypermethylation being the principal inactivating mechanisms. Therefore, p16, but not p14, seems to be the primary target of inactivation at the INK4a locus in bile duct cancers. Other mechanisms than Tp53 mutations seems to be predominantly responsible for stabilization of nuclear p53 protein in bile duct cancers. Copyright 2002 Wiley-Liss, Inc.
UI - 11780432
AU - Wang C; Lu X; Liu G; Dai L; Xu T; Chen Y; Gao C; Wen X; Qian J
TI - Detailed deletion mapping on chromosome region 9p21 in human periampullary neoplasms.
SO - Chin Med J (Engl) 2001 Jun;114(6):588-91
AD - Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China. email@example.com
OBJECTIVE: To further define the extent of chromosome 9p21 deletion in periampullary neoplasms. METHODS: The loss of heterozygosity at 5 microsatellite polymorphic markers on chromosome 9p21 was detected by polymerase chain reaction (PCR), polyacrylamide gel electrophoresis (PAGE) and silver staining in 35 specimens of periampullary neoplasms and their matching blood samples. RESULTS: Fifty percent (4/8) of pancreatic cancer cases showed the loss of heterozygosity at one or more microsatellite loci, with the more frequent sites of D9S974 (37.5%) and D9S942 (28.6%), and some showing consecutive allelic loss. Sixty-two point five percent (5/8) of ampullary carcinoma cases showed loss of heterozygosity at one or more of the loci, frequent site of loss being D9S942 (42.9%) and the next most frequent being IFNA (37.5%) and D9S171 (37.5%). Loss of one locus was observed in 14.2% (1/7) of insulinoma. CONCLUSION: The minimal common region of chromosome deletion in periampullary neoplasms is defined between the D9S974 and D9S942 loci within a 15 kb interval in 9p21, suggesting the involvement of a novel tumor suppressor gene in their carcinogenesis.
UI - 11569922
AU - Chen Y; Satoh T; Sasatomi E; Miyazaki K; Tokunaga O
TI - Critical role of type IV collagens in the growth of bile duct carcinoma. In vivo and in vitro studies.
SO - Pathol Res Pract 2001;197(9):585-96
AD - Department of Pathology, Saga Medical School, Japan. firstname.lastname@example.org
Most extrahepatic bile duct carcinomas (EBDC) are characterized by a striking stromal response (desmoplasia). Our previous studies showed deposition of type IV collagen in the desmoplastic stroma beyond the basement membrane. Although type IV collagen is expressed in EBDC, little is known about the pattern of deposition in tumor stroma and how this matrix component influences the behavior of tumor cells. With the progression of desmoplasia in EBDC, different changes occurred in the quantity and localization of type IV collagen from that of type I collagen. Type I collagen was diffusely distributed in the stroma and appeared to be concentrated in the center of the tumors. In contrast, type IV collagen was deposited in the interstitium alongside carcinoma cells at the tumors' periphery. Weak or no type IV collagen deposition was detected in the more central portion of the tumors containing sclerotic collagens. To investigate the role of stromal type IV collagen in tumor cell proliferation, EBDC cell lines were cultured in a three-dimensional matrix containing varying compositions of type I collagen and type IV collagen. They were also assayed for cell adhesion and migration using in vitro models. Type IV collagen more extensively stimulated tumor cell proliferation, adhesion and migration in a dose-dependent manner than did type I collagen. All of these results suggest that modified tumor stroma with the presence of type IV collagen in EBDC provides a better environment for tumor growth and invasion.
UI - 9424866
AU - Knast W; Markocka-Maczka K; Wierzbicki J; Wozniak S; Nienartowicz M;
TI - Pelczar P [Tumor in Vater's ampulla--local excision or Whipple's resection]
SO - Wiad Lek 1997;50 Suppl 1 Pt 2():158-61
AD - Katedry i Kliniki Chirurgii Przewodu Pokarmowego Akademii Medycznej we Wroclawiu.
Results of the operative treatment of Vater's papilla carcinoma in fifteen cases were analysed. Eleven patients had pancreatoduodenectomy according to Whipple, four had only local excision of Vater's papilla along with the tumour. All four had early recurrence and were re-operated by Whipple method. In our experience only radical pancreatoduodenectomy with regional lymphadenectomy, preferably Whipple type, gives chance of achieving the radical cure.
UI - 11796009
AU - Matsuo K; Kuroki T; Kitaoka F; Tajima Y; Kanematsu T
TI - Loss of heterozygosity of chromosome 16q in gallbladder carcinoma.
SO - J Surg Res 2002 Feb;102(2):133-6
AD - Department of Surgery II, Nagasaki University School of Medicine, Nagasaki 852-8501, Japan. email@example.com
BACKGROUND: The present study was planned to investigate cumulative genetic changes during development and progression of gallbladder carcinoma (GBC) in clinical patients. MATERIALS AND METHODS: We examined GBC DNA from resected tissue isolated from 56 cases of GBC for loss of heterozygosity (LOH) at six loci on five chromosomal arms (1p36, 9p21, 13q14, 16q24, 17p13), using highly polymorphic microsatellite markers. RESULTS: High incidences of LOH at 1p36 (19/36: 53%), 9p21 (12/32: 38%), 13q14 (20/36: 56%), 16q24 (31/54: 61%), and 17p13 (15/36: 42%) were detected. When comparing genetic features with clinicopathological stages of these tumors, it appeared that only LOH at 16q24 had a high incidence (5/6: 83%) at an early stage (T1a: tumor invades lamina propria) of the disease, although large numbers of LOH were found on all chromosomal arms in tumors of more advanced stages (T1b, T2, T3, and T4). CONCLUSION: These results suggested that the putative tumor suppressor gene on 16q24 may be strongly related to an early step of carcinogenesis in GBC and that GBC acquires a high malignant potential when the tumor invades the muscle layer. (c)2001 Elsevier Science.
UI - 11747335
AU - Oshikiri T; Hida Y; Miyamoto M; Hashida H; Katoh K; Suzuoki M; Nakakubo
TI - Y; Hiraoka K; Shinohara T; Itoh T; Kondo S; Katoh H RCAS1 as a tumour progression marker: an independent negative prognostic factor in gallbladder cancer.
SO - Br J Cancer 2001 Dec 14;85(12):1922-7
AD - Department of Surgical Oncology, Division of Cancer Medicine, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, 060-8638, Japan.
Receptor-binding cancer antigen expressed on SiSo cells (RCAS1) induces apoptosis in immune cells bearing the RCAS1 receptor. We sought to determine RCAS1 involvement in the origin and progression of gallbladder cancer, and also implications of RCAS1 for patient survival. RCAS1 expression was examined immunohistochemically in 110 surgically resected gallbladder specimens. The gallbladders represented 20 cases of cholecystitis with no associated pancreaticobiliary maljunction; 23 cases of cholecystitis with pancreaticobiliary maljunction; 14 cases of adenomyomatosis; 7 adenomas; and 46 cancers. High expression of RCAS1 (immunoreactivity in over 25% of cells) was observed in 32 of the 46 cancers (70%), but not in other diseases, including pre-cancerous conditions. RCAS1 immunoreactivity was associated with depth of tumour invasion (P = 0.0180), lymph node metastasis (P = 0.0033), lymphatic involvement (P = 0.0104), venous involvement (P = 0.0224), perineural involvement (P = 0.0351) and stage by the tumour, nodes and metastases (TNM) classification (P = 0.0026). Thus, RCAS1 expression may be a relatively late event in gallbladder carcinogenesis, possibly promoting tumour progression. Cox regression multivariate analysis demonstrated RCAS1 positivity to be an independent negative predictor for survival (P = 0.0337; risk ratio, 12.690; 95% confidence interval, 1.216-132.423). High expression of RCAS1 significantly correlated with tumour progression and predicted poor outcome in gallbladder cancer.
UI - 11830924
AU - Eriguchi N; Aoyagi S; Tamae T; Nishimura K; Hamada S; Kawabata M; Kodama
TI - T; Jimi A Carcinoma of the ampulla of Vater associated with other organ malignancies.
SO - Kurume Med J 2001;48(4):255-9
AD - Department of Surgery, Sasebo Kyosai Hospital, 10-17 Shimanji-cho, Sasebo 857-8575, Japan.
Because of its location with respect to the biliary system, carcinoma of the ampulla of Vater is considered to manifest earlier in its course of development than carcinoma of the pancreas. The most common physical finding is jaundice, which occurs in 93-100% of cases [1,2]. This retrospective study describes the results of the treatment and prognosis for double primary cancers in which cancer of the ampulla of Vater was associated with malignancies in other organs in 5 patients who were diagnosed and treated at Kurume University Hospital. The patients included 5 men with an average age of 72.8 years. There were 3 synchronous double and 2 metachronous double cancer patients. Regarding prognoses of these patients, 1 patient with associated lung cancer died because of postoperative complications after pneumonectomy, 1 patient died due to carcinomatosa peritonei developing from the ampulla Vater carcinoma, and 1 patient died because of metastatic liver tumors from the ampullary carcinoma. In multiple cancers including ampulla Vater carcinoma, gastrointestinal cancers such as gastric or colon cancer occur frequently. Therefore, a careful gastrointestinal examination should be done preoperatively. We report our experience with 5 cases of ampullary carcinoma associated with malignancies in other organs and review the literature.
UI - 11830926
AU - Kinoshita H; Hashino K; Hashimoto M; Kodama T; Nishimura K; Kawabata M;
TI - Furukawa S; Tamae T; Nagashima J; Hara M; Imayama H; Aoyagi S Clinicopathological evaluation of surgical treatment for early gallbladder cancer.
SO - Kurume Med J 2001;48(4):267-71
AD - Department of Surgery, Kurume University School of Medicine, Kurume 830-0011, Japan.
We evaluated the therapeutic principles for early gallbladder cancer based on clinicopathological characteristics and outcomes in 27 patients encountered at the Kurume University Hospital between January, 1975 and December, 1999. Concerning the depth of wall penetration, 15 patients had mucosal cancers (m-cancers), and 12 patients muscularis propria cancers(mp-cancers). The gross patterns were lp (pedunculated) in 16 patients, ls (sessile) in 3 patients, IIa (flat elevated) in 4 patients, and IIb (flat) in 4 patients. The operative procedure used was cholecystectomy (C) in 12 patients, 4 of whom underwent lymph node dissection. Full-thickness cholecystectomy (FTC) was carried out in 3 patients, one of whom had lymph node dissection. Combination of C and gallbladder bed resection (GbBR) was performed in 7 patients, 6 of whom had lymph node dissection. Combination of C and bile duct resection (BDR), and lymph node dissection was performed in 1 patient. Combination of C and GbBR and BDR, and lymph node dissection was performed in 6 patients. All the patients who underwent lymph node dissection were negative for metastasis. Of the 27 patients, 2 underwent laparoscopic operation: one with m-cancer was 79 years old, and the other with mp-cancer 86 years old. In the m-cancers, no lymphatic, venous or perineural infiltration was observed. In contrast, in the mp-cancers, lymphatic and venous infiltration each were observed in 4 patients (33.3%), although no perineural infiltration was observed. A diagnosis of gallbladder cancer was made postoperatively in 6 patients, of whom 4 had the IIb pattern and all were complicated by gallstone, indicating the difficulty of diagnosing the IIb pattern. The 5-year survival rates for the m- and mp-cancers were as high as 90.9% and 80.8%, respectively. As a curative surgical technique for m- and mp-cancers, lymph node dissection should be performed in addition to FTC, GbBR, and BDR, in combination. When a postoperative histopathologic diagnosis of gallbladder cancer has been made, no second-look operation should be performed for m-cancers, but lymph node dissection of up to the second group should be performed for mp-cancers in a second-look operation.
UI - 11848630
AU - Wagholikar GD; Behari A; Krishnani N; Kumar A; Sikora SS; Saxena R;
TI - Kapoor VK Early gallbladder cancer.
SO - J Am Coll Surg 2002 Feb;194(2):137-41
AD - Department of Surgical Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
BACKGROUND: The majority of patients with gallbladder cancer (GBC) have advanced disease at the time of diagnosis and are unresectable. Longterm survival is usually seen in a subset of patients with early GBC (EGBC)-cancer confined to the mucosa (pT1a) and muscularis (pT1b). Management guidelines of EGBC are not yet defined and are controversial. The purpose of this article is to evaluate the diagnostic aspects and effects of resectional procedures on survival outcome in patients with EGBC. STUDY DESIGN: EGBC was defined as cancer confined to the mucosa (pT1a) or muscularis (pT1b) according to the TNM classification. Clinicopathological details and survival data of 14 patients who had EGBC were analyzed. There were 9 women and 5 men, with a mean age of 60 years. RESULTS: A definite preoperative diagnosis was possible in only three patients and three patients were diagnosed at surgery; the majority of patients were diagnosed incidentally after cholecystectomy for associated gallstones. Two patients underwent extended cholecystectomy and 12 patients underwent simple cholecystectomy. Two patients had pT1a and 12 had pT1b lesions. Mean (SD) survival was 71.5 (12.2) months and median survival was 42 months. There were five treatment failures with locoregional recurrence and death. All patients with pT1b tumors were treated by simple cholecystectomy. Cumulative 1-, 3-, and 5-year survival was 92%, 68%, and 68% respectively. CONCLUSIONS: Simple cholecystectomy is an adequate treatment only for mucosal GBC. Patients with pT1b tumors require extended cholecystectomy. Incidental GBC extending up to the muscularis merits early reoperation for completion of extended cholecystectomy, which offers the only chance of cure.
UI - 11579805
AU - Fong Y; Malhotra S
TI - Gallbladder cancer: recent advances and current guidelines for surgical therapy.
SO - Adv Surg 2001;35():1-20
AD - Cornell University Medical College, Memorial Sloan-Kettering Cancer Center, New York, USA.
UI - 11804747
AU - Hui AM; Shi YZ; Li X; Sun L; Guido T; Takayama T; Makuuchi M
TI - Proliferative marker Ki-67 in gallbladder carcinomas: high expression level predicts early recurrence after surgical resection.
SO - Cancer Lett 2002 Feb 25;176(2):191-8
AD - Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. huia@mail,nih.gov
To evaluate the prognostic value of proliferative maker Ki-67, its expression was determined immunohistochemically in 37 gallbladder carcinomas (GBCs). A high Ki-67 index was significantly correlated with tumor lymphatic invasion (P=0.007) and vascular invasion (P=0.04). High Ki-67 index group and low Ki-67 index group showed different clinical courses. Five patients who experienced recurrences in high Ki-67 index group developed their recurrent diseases within one year after surgery and died soon after recurrence, while the recurrences (five cases) in low Ki-67 index group were distributed all stages after surgery. In conclusion, high Ki-67 index predicts early recurrence after surgery for GBCs.
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