title: A retrospective analysis of patients with gallbladder cancer treated with radical resection versus cholecystectomy plus external radiotherapy.
abstract: 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.
authors.affiliation: Department of Gastroenterology, Instituto Nacional de Cancerologia, Av. Hidalgo No. 411, Colonia Centro C.P. 50000, Toulca, Estado de México, Mexico. rymmondragon@aol.com
authors.forename: Ricardo
authors.initials: R
authors.lastname: Mondragón-Sánchez
authors.forename: Manuel
authors.initials: M
authors.lastname: González-Geroniz
authors.forename: Luis Fernando
authors.initials: LF
authors.lastname: Oñate-Ocaña
authors.forename: Ana Lilia
authors.initials: AL
authors.lastname: Garduño-López
authors.forename: Alejandro
authors.initials: A
authors.lastname: Mondragón-Sánchez
authors.forename: Rigoberto
authors.initials: R
authors.lastname: Bernal-Maldonado
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Ruiz-Molina
mesh_terms: 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