gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

Factors influencing the prognosis of incidental gallbladder carcinoma

Meeting Abstract

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  • corresponding author presenting/speaker Thorsten Götze - Chirurgische Klinik Ketteler- Krankenhaus Offenbach, Deutschland
  • Vittorio Paolucci - Chirurgische Klinik Ketteler- Krankenhaus Offenbach

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPO184

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Veröffentlicht: 20. März 2006

© 2006 Götze et al.
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Introduction: More than 75% of cholecystectomies are done laparoscopically and less than one third of the gallbladder carcinomas are known preoperatively.

Since the first description of port site metastases in 1991 and tumor cell seeding in 1994 it is supposed that the laparoscopic technique could worsen the prognosis of gallbladder cancer.

These assumptions are going to be verified by the CAES/ CAMIC- register.

Material and method: The Workgroup Surgical Endoscopy (CAE) of the German Society of Surgery has started in 1997 a register of all cases of cholecystectomy – laparoscopic as well open – with a postoperative incidental finding of gallbladder carcinoma. The aim of our register is to compare the prospectively collected follow up data on the outcome of these patients and to answer the question, among other questions whether laparoscopic cholecystectomy affects the course and the prognosis of patients with incidental gallbladder cancer.

Results: 417 cases of incidental gallbladder cancer have been recorded from more than 200 different hospitals so far.

There are 221 patients treated by the laparoscopic procedure, 130 by the open one, 66 with an intraoperative conversion from the laparoscopic to the open procedure for non oncological reasons.

Following the laparoscopic procedure we registered 15 port site metastases, following the open primary procedure 9 wound recurrences.

A peritoneal carcinosis is reported in 63, a local recurrence in 53 cases.

143 of the 417 patients underwent a second radical oncological resection.

It seems to be a tendency that reoperated T1- and T2 tumors have a better survival than those without a reoperation. (log- rank > 0.05)

The survival- rate (Kaplan- Meier) shows a significant better survival for the laparoscopic procedure in comparison with the primary open (p= 0,0127) or converted group (p=0,0191).

The median survival for laparoscopic and open treated T1- tumors is about 55%, for laparoscopic treated T2- tumors 40% and open treated T2- tumors 30%.

Discussion: The survival time is higher for the laparoscopic treated ones and that cannot be explained with the fact that the laparoscopic technique treats the earlier stages.

The access technique, open or laparoscopic does not seem to influence the prognosis of incidental gallbladder carcinoma.

Until now we could not find a disadvantage for the laparoscopically operated group.