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Revista médica de Chile

Print version ISSN 0034-9887

Abstract

ROA E, ván et al. Pathological findings in surgical reinterventions for gallbladder cancer in patients with and without preoperative chemo and radiotherapy. Rev. méd. Chile [online]. 2001, vol.129, n.9, pp.1013-1020. ISSN 0034-9887.  http://dx.doi.org/10.4067/S0034-98872001000900006.

Background: The usefulness of surgery in the treatment of gallbladder cancer has not been clearly established. The benefits of chemo and radiotherapy are similarly dubious. Aim: To report the pathological findings in patients subjected to surgical reinterventions for gallbladder cancer. Patients and methods: We report 54 patients with gallbladder cancer that were subjected to a second surgical intervention for resection of liver segments IVb and V and lymph nodes corresponding to the liver hilar, portal, peripancreatic, celiac artery and periaortic territories. Thirteen of these patients were subjected to preoperative chemo-radiotherapy (4500 Gy and 5-fluouracil 500 mg/m2). Results: Lymph node metastases were found in 25 and 38%, and liver metastases in 25 and 28% of patients with or without chemo-radiotherapy respectively. The most frequent pathological findings attributed to radiation in the liver were fatty infiltration in 75% of cases, vascular transformation in 83% of cases and minimal periportal lymphocyte infiltration in 40% of cases. Lymph nodes were atrophic in 67% of cases and had foci of cortical necrosis in 46% of cases. Three cases had regional lymph node and liver metastases. Most tumor cells were viable. Conclusions: No differences in the number of lymph node or liver metastases were observed between patients with and without chemo-radiotherapy. No effect of the treatment on residual tumor was observed either (Rev Méd Chile 2001; 129: 1013-20

Keywords : Chemotherapy, adjuvant; Gallbladder neoplasms; Radiotherapy, adjuvant; Surgical procedures.

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