TITLE:
Recurrence Factors of Localized Gallbladder Cancer
AUTHORS:
Salah Berkane, Mohamed Cherifi, Faiza Taib, Sabeha Belhouas, Abdellah Boudiaf, Ibtissem Bezghoud, Salim Belkherchi
KEYWORDS:
Localized Gallbladder Cancer, Radical Surgery, Recurrence Factor
JOURNAL NAME:
Surgical Science,
Vol.16 No.4,
April
27,
2025
ABSTRACT: Introduction: The localized gallbladder cancer can be cured when it is radically resected. But even in this favorable form of disease, tumoral recurrence will occur in some cases. The aim of this retrospective study is the recognize factors that are associated with tumoral recurrence. Material and Method: All tumors that do not extend the serous layer of the gallbladder wall and are treated with radical surgery were included in this retrospective study. Several factors, such as clinical, biological and histological, were retrospectively analyzed. We divided patients into two groups: group A with recurrence and group B without recurrence. Results: One hundred-twenty-two patients were included. The group A was constituted by twenty-nine patients (23.8%) and ninety-three patients constituted the group B. Univariate analysis of the 2 groups shows that lymph node involvement, serosal involvement, the presence of vascular emboli, the presence of perineural sheathing, and capsular rupture of the lymph nodes have a negative impact on tumor recurrence. In multivariate analysis, only 4 elements favor the risk of recurrence which are lymph node involvement with a number of lymph nodes equal to or greater than 4 nodes, a high CA 19.9 rate, serosa involvement (pT3) and stage III of the ASA classification. Near all recurrences (96.6%) were located in the peritoneal cavity and their four sites are represented by peritoneal carcinomatosis, the main bile duct, hepatic metastases and lymph nodes. The 5-year survival is 3.4% in group A (patient died 85 months after her recurrence and after palliative secondary resection) and 83.7% in group B. Conclusion: The 4 factors predicting tumoral recurrence isolated in our study, can help to provide a new approach in the radical surgery of the localized form of gallbladder cancer to improve its prognosis. We propose to add efficacious adjuvant therapy for patients with these predicting factors of recurrence after radical surgery.