title: Poor prognosis of gallbladder cancer persists regardless of improved diagnostic methods. Incidence and results of surgery during 20 years in Helsinki.
abstract: OBJECTIVE
  The ominous prognosis of primary gallbladder cancer is well-known. This study assesses whether the prognosis has improved, and whether the substantial development in the radiologic imaging techniques is reflected in the survival of these patients.
  
  
  METHODS
  The series consisted of 122 patients operated on for primary cancer in the gallbladder in the Helsinki City area between 1970 and 1990.
  
  
  RESULTS
  The mean age of the patients was 68.6 years and did not change during the period, but there was a significant proportional increase in male patients. Only 2% of patients had a localized disease at the time of diagnosis, and there was no improvement in the diagnostic sensitivity during the observation period. Yet, the number of unexpected postoperative cancer diagnoses increased from 4% to 15% during the two decades. The primary mortality decreased from 21% to 13%, the one-year survival increased from 7% to 13%, whereas the five-year survival remained unchanged.
  
  
  CONCLUSIONS
  During the past two decades the frequency of surgery for primary gallbladder cancer has increased significantly among males in the Helsinki City area. Regardless of the improved immediate survival the long-term survival has remained poor. The marked development in radiologic techniques is not reflected in the prognosis of these patients. Even under conditions in which the potential for the diagnosis of a malignant gallbladder disease is available, the opportunities for radical surgery are not utilized maximally, which is a cause for concern.
authors.affiliation: II Department of Surgery, Helsinki University Central Hospital, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Paimela
authors.forename: A
authors.initials: A
authors.lastname: Karppinen
authors.forename: K
authors.initials: K
authors.lastname: Höckerstedt
authors.forename: V
authors.initials: V
authors.lastname: Perhoniemi
authors.forename: E
authors.initials: E
authors.lastname: Vaittinen
authors.forename: E
authors.initials: E
authors.lastname: Kivilaakso
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002763:Cholecystectomy; D003430:Cross-Sectional Studies; D003952:Diagnostic Imaging; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000175:diagnosis / Q000401:mortality; D015996:Survival Rate