A retrospective analysis of patients with gallbladder cancer treated with radical resection versus cholecystectomy plus external radiotherapy.
OBJECTIVE
To compare patients with gallbladder cancer treated with radical resection and regional lymphadenectomy (RR-RL) versus simple cholecystectomy and adjuvant external radiotherapy (SC-ERT) and determine outcome.


METHODS
Presentation, operative data, complications and survival were examined in 137 patients. In particular, the 45 patients treated with RR-RL or SC-ERT.


RESULTS
Twenty-five had SC-ERT and 20 had a RR-RL. There were no epidemiological differences between groups. Resection of segments IV-b and V and en bloc dissection of regional lymph nodes was the most frequently used procedure (75%). The morbidity and mortality of the radical procedure were 25% and 10%. The morbidity of SC-ERT was 16%. All patients with Nevin I are alive. For lesions Nevin II and Nevin III RR-RL offered a 100% 5-year survival rate and SC-ERT had a 62% and 39% 5-year survival rate respectively. For lesions Nevin IV and V there was no difference in long-term survival.


CONCLUSIONS
RR-RL is better than SC-ERT in patients with Nevin II and III lesions because it improves survival rate. SC-ERT can be recommended as an alternative treatment. For more advanced lesions further trials are needed.
Mondragón-Sánchez
Ricardo
R
Department of Gastroenterology, Instituto Nacional de Cancerologia, Av. Hidalgo No. 411, Colonia Centro C.P. 50000, Toulca, Estado de México, Mexico. rymmondragon@aol.com
González-Geroniz
Manuel
M
Oñate-Ocaña
Luis Fernando
LF
Garduño-López
Ana Lilia
AL
Mondragón-Sánchez
Alejandro
A
Bernal-Maldonado
Rigoberto
R
Ruiz-Molina
Juan Manuel
JM
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D000328:Adult; D000368:Aged; D002173:Cancer Care Facilities; D002763:Cholecystectomy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005704:Gallbladder / Q000473:pathology; D005706:Gallbladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008800:Mexico; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate