EARLY RECURRENCE OF CARCINOMA GALL BLADDER AFTER R0 RESECTION OF STAGE T1B-T3

Objective:The time to tumour recurrence after curative intent excision can predict the prognosis of hepatobiliary malignancies. As a result, we studied the risk factors for early recurrence of gallbladder cancer and related prognosis in patients with T1b–T3 gallbladder carcinoma who had received R0 resection.

Material and Methods:Total of 18patients who underwent R0 resection for gall bladder carcinoma of stage T1b–T3 between March 2009 and Feb 2017at Hayatabad Medical Complex Peshawar Pakistan were included in the study. The exclusion and inclusion criteria were strictly followed.Logisticregressionmodelswereusedtoidentifytheriskfactorsforearlyrecurrence.

Results:Atthetimeofradical surgery the type of resection consisted primarily of cholecystectomy with partial hepatic resection was (n=15, 83.3%). Resection of regional lymph nodes was performed routinely in all patients. Pathologically most patients had tumors at stage I&II (n=13, 72.2%).Postoperatively5(27.7%) patients hadatleastonecomplication&almost 2 (11.1%) individuals developed major complications,theoverallmorbiditywas 4(22.2%).Overall survival rate at1,3, and 5 years was 15(83.3%),11(61.1%) and6(33.3%)respectively. Total of 7(38.8%) patients experienced tumor recurrence after treatment, amongthem 4 (57.1%) developed a local recurrence, while 1(14.2%) developed distant recurrence and 2(28.5%) experienced both local and distant recurrence. The liver parenchyma 3(42.8%) was the most prevalent site of relapse.

Conclusion: T3 stage, N1–N2 stage, poor differentiation and lymphovascular invasion were independent risk factors associated with early recurrence for patients with gall bladder carcinoma with stage T1b–T3 disease after R0 resection.