title: Five-year survivors after aggressive surgery for stage IV gallbladder cancer.
abstract: OBJECTIVE
  To describe 5-year survivors after radical surgery for stage IV gallbladder cancer and to determine the characteristics leading to potential long-term survival.
  
  
  METHODS
  Of 59 patients undergoing radical resection for stage IV disease between 1979 and 1994, 6 patients who have survived for more than 5 years were followed up.
  
  
  RESULTS
  Three patients had developed obstructive jaundice due to involvement of the hepatic hilum, but the other three had not. The jaundiced patients had remarkable tumor spread over the bile duct and right hepatic artery within the hepatoduodenal ligament. However, the proper and left hepatic arteries and the portal trunk and its left branch were free from tumor involvement. The nonjaundiced patients had N1 or N2 lymph node metastasis. However, none underwent bile duct resection or pancreatoduodenectomy to establish radical lymphadenectomy.
  
  
  CONCLUSIONS
  Selected patients with stage IV gallbladder cancer may be candidates for 5-year survival when the primary tumor is fairly localized even if it forms a large mass and involves neighboring organs including the hepatic duct, lymph node metastasis is limited to N1 and N2 except for the celiac and superior mesenteric nodes and is less infiltrative, and distant metastasis including that in the paraaortic area is absent.
authors.affiliation: First Department of Surgery, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kondo
authors.forename: Y
authors.initials: Y
authors.lastname: Nimura
authors.forename: J
authors.initials: J
authors.lastname: Kamiya
authors.forename: M
authors.initials: M
authors.lastname: Nagino
authors.forename: M
authors.initials: M
authors.lastname: Kanai
authors.forename: K
authors.initials: K
authors.lastname: Uesaka
authors.forename: N
authors.initials: N
authors.lastname: Yuasa
authors.forename: T
authors.initials: T
authors.lastname: Sano
authors.forename: N
authors.initials: N
authors.lastname: Hayakawa
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005706:Gallbladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D016577:Pancreaticoduodenectomy; D015996:Survival Rate