Factors affecting surgical outcome for gallbladder carcinoma.
OBJECTIVE
The outcome of advanced gallbladder carcinoma is dismal despite aggressive surgery. The aim of this study was to evaluate the surgical outcome and prognostic factors for patients with gallbladder carcinoma and to identify patients who may benefit from radical surgery.


METHODS
Fifty-six patients who underwent surgical resection of gallbladder carcinoma were retrospectively reviewed. Their tumor markers, operative management, pathological factors and survival were analyzed.


RESULTS
The serum carcinoembryonic antigen level was elevated in 9 of 51 patients (18%) with data available as was the serum carbohydrate antigen 19-9 level in 14 of 47 patients (30%). Univariate analysis showed that jaundice, serum carcinoembryonic antigen and carbohydrate antigen 19-9 levels, the number, size, macroscopic type, and histological grade of the tumor, the depth of tumor invasion (pT), pathological stage, lymph node metastasis (pN), lymphatic invasion, vascular invasion, perineural infiltration, curability of lymph node dissection and surgical margins have prognostic significance for survival. Multivariate analysis revealed jaundice, high histological grade, pT3 or pT4, and surgical margins were independent prognostic factors for survival.


CONCLUSIONS
Preoperative serum carcinoembryonic antigen and carbohydrate antigen 19-9 levels are potential predictors and informative for survival. There are still difficulties to treat gallbladder carcinoma infiltrating beyond subserosa or revealing jaundice.
Noshiro
Hirokazu
H
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Chijiiwa
Kazuo
K
Yamaguchi
Koji
K
Shimizu
Syuji
S
Sugitani
Atsushi
A
Tanaka
Masao
M
D000368:Aged; D018395:CA-19-9 Antigen / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood; D002763:Cholecystectomy / Q000379:methods; D005260:Female; D005706:Gallbladder Neoplasms / Q000097:blood / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen