title: Factors affecting surgical outcome for gallbladder carcinoma.
abstract: 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.
authors.affiliation: Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Noshiro
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chijiiwa
authors.forename: Koji
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Syuji
authors.initials: S
authors.lastname: Shimizu
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sugitani
authors.forename: Masao
authors.initials: M
authors.lastname: Tanaka
mesh_terms: 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
chemical_list: D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen