GALLBLADDER CANCER AND TROCAR SITE RECURRENCES

BACKGROUND: Critics of laparoscopic surgery cite an increased incidenc e of tumor recurrence at the trocar sites following laparoscopic chole cystectomy in patients incidentally found to have carcinoma of the gal lbladder. The purpose of this review was to determine if laparoscopic cholecystectomy performed in patients with gallbladder cancer results in an increased incidence of abdominal wall recurrences. METHODS: The charts of all patients with gallbladder cancer registered at the Unive rsity of Texas M. D. Anderson Cancer Center from January 1991 through April 1996 were retrospectively reviewed. Data were collected on initi al and subsequent surgical procedures, tumor grade and histology, T st age, adjuvant therapy, and survival. These data were analyzed with reg ard to abdominal wall recurrences and outcome. RESULTS: Ninety-three p atients with gallbladder cancer were seen during this period; 79 patie nts with complete follow-up information comprised the study population . Comparison of the incidence of abdominal wall recurrences among the categories of surgical procedure (laparoscopic versus open versus lapa roscopic converted to open) did not reveal any statistically significa nt differences. Overall 5-year survival was 10%. CONCLUSIONS: Gallblad der cancer is an aggressive malignancy with few long-term survivors. I n addition, these data show that the incidence of abdominal wall impla ntation is not increased with laparoscopic surgery but is more likely a manifestation of the aggressive nature of this tumor. (C) 1997 by Ex cerpta Medica, Inc.