The relationship between surgery and prognosis of gallbladder carcinoma.
OBJECTIVE
To explore the prognostic factors of gallbladder carcinoma and the relationship between operative procedure and prognosis of gallbladder carcinoma.


METHODS
A retrospective clinical analysis was made in 56 patients with gallbladder carcinoma who had undergone surgery at our department from 1995 to 2001.


RESULTS
Of the 56 patients, 20 were men and 36 women with a male to female ratio of 1:1.56. Their age ranged from 41 to 79 years with a mean of 59.6 years. Thirty-four patients suffered from gallstones. Abdominal pain (83.9%) and jaundice (41.1%) were the main symptoms. Thirty patients (Nevin stage II in 5 patients, III in 3, IV in 4, and V in 18) received radical or extended radical resection; non-radical resection was performed in 11 patients of Nevin stage V; and 15 patients of Nevin stage V were subjected to biopsy with or without palliative bypass procedure. Statistical analysis showed that operative procedure, staging of Nevin, and gallstone affected significantly postoperative survival, but age, sex, preoperative serum bilirubin level, numbers of tumor location, histopathological type and grade were not significant prognostic factors. After radical resection was classified with Nevin staging, we found that all the patients of stage II were alive. Meanwhile the postoperative survival periods of radical resection groups of stage III to V, palliative resection group, and biopsy with/without palliative drainage group were statistically different.


CONCLUSIONS
From Nevin stage II to V, the survival period of respective stage group, which treated with curative operation, became shorter gradually. In those patients of stage V, the survival period of curative operation group was longer than that of palliative resection group, and that of the latter was better than that of biopsy with/without palliative drainage group. So radical resection was still the unique way to better prognosis.
Zhang
Bai-He
BH
Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Shanghai 200438, China. billyyi@citiz.net
Yi
Bin
B
Peng
Lin-Hui
LH
Zhang
Bao-Hua
BH
Jiang
Xiao-Qing
XQ
Wu
Meng-Chao
MC
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001707:Biopsy, Needle; D002277:Carcinoma / Q000401:mortality* / Q000556:secondary / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy / Q000379:methods* / Q000401:mortality; D005260:Female; D005706:Gallbladder Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011336:Probability; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D017678:Sex Distribution; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome