胆嚢癌における同時性肝転移に関する臨床病理学的研究

概要

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This study aimed to clarify the location of metastases and the related clinicopathological factors in resectable cases of synchronous liver metastasis from carcinoma of the gallbladder (LmGbCa), and to clarify the procedure for surgical management of LmGbCa. One hundred fifty five patients with a depth of invasion of more than the subserosal (ss) cancer were subjected to the study and 29 of the patients (19%) were found to have LmGbCa. Clinicopathological results indicated that the LmGbCa cases showed significant correlations with hinf3 (p<0.05), a depth of invasion of more than ss (p<0.05), Iy3 (p<0.05), v3 (p<0.01), and the location of the primary lesion on hep or circ (p<0.01). We found that the prognosis of HI patients was better than that of H2～3 patients, and that in postoperative survival rates there was a significant difference between cases with five or less liver metastatic tumors and cases with more than 6 (p< 0.01). As many as 50% of the hinf-negative patients and 67% of the patients with direct infiltration of the liver bed had metastatic liver tumors being located only at the liver bed. These findings suggest that in HI and H2 patients with 5 or less metastatic tumors should be an indication for surgical management. We should choose hepatectomy of s4a and s5 segments even with advanced carcinoma of the gallbladder with or without slight infiltration into the hepatic floor (hinf1 and hinf0).
東京女子医科大学の論文
1996-07-25