Gallbladder cancer in Chile. A report on 54 potentially resectable tumors.
Fifty-four patients with potentially resectable gallbladder tumors, chosen from 205 cases diagnosed at the Pathologic Unit of the authors' institution, were included in a prospective protocol of management. Of the potentially resectable tumors, only four were indicated before cholecystectomy (7.4%). Inconspicuous tumors were frequently observed, explaining in part the poor results of ultrasonogram for diagnosis. Poorly differentiated tumors were related to a greater rate of metastasis and shorter survival. Likewise, younger patients were associated with a worse prognosis. Patients with tumor confined to the mucosal layer were followed-up only during their postoperative courses. Patients with tumor involvement of the subserosa or muscular layer were offered treatment of a second operation, which included a lymphadenectomy and a liver wedge resection. For patients with serosal involvement, a more aggressive approach was proposed. Metastatic lymph node involvement was found in 9 of the 25 (36%) patients in whom dissection was performed. However, tumor invasion of the liver was seen in 10 of the 24 (41.6%) patients who underwent a liver resection. Patients who had a curative resection had a significantly longer survival in comparison with those who had a palliative resection or simple cholecystectomy.
de Aretxabala
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Department of Surgery, Universidad de la Frontera, Temuco, Chile.
Roa
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I
Burgos
L
L
Araya
J C
JC
Fonseca
L
L
Wistuba
I
I
Flores
P
P
D000230:Adenocarcinoma / Q000453:epidemiology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000601:surgery*; D002677:Chile / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013514:Surgical Procedures, Operative / Q000379:methods; D016019:Survival Analysis