[The long-term results of managements in 98 cases of gallbladder carcinomas].
OBJECTIVE
Carcinoma of the gallbladder is an uncommon, but patients with the disease are associated with a dismal prognosis. The purpose of this study was to analyze the characters, prognostic factors of gallbladder carcinoma and investigate the measures of diagnosis and treatment.


METHODS
98 patients admitted into our hospital from January 1992 to July 2000 were followed up, with a mean follow-up time of 478 days (1 - 2,280 days). All statistical analyses were performed with SPSS10.0 statistical package. Survival curves were estimated by the Kaplan-Meier method and differences among groups were tested by the log-rank test. The Cox multivariate analysis was performed to determine prognostic factors on survival.


RESULTS
Among 98 patients, 31 with radical resection, 29 with palliative resection, 18 with exploration and 20 with chemo- and/or radiotherapy, The overall 5-year survival rate of the gallbladder carcinoma was 6.67%, The 1-, 3-, and 5-year survival rate following radical resection for gallbladder cancer was 77.29%, 34.37%, 21.48% respectively, The survival rate in radical resection group was remarkably higher than that of the others (P < 0.01). Multivariate analysis revealed that tumor, node, metastases (TNM) stage and therapeutic interventions had significantly higher risk ratios for gallbladder cancer.


CONCLUSIONS
With careful patient selection, aggressive resection may help to improve the prognosis, although the disease with ominous reputation. Resection alone is inadequate for a significant improvement in survival, so there is a need to evaluate more effective adjuvant therapy in the form of radiotherapy or newer chemotherapeutic agents. Emphasis to improve the long-term survival should be pay on early diagnosis and early management.
Zheng
Shu-sen
SS
Department of Hepatobiliary Pancreatic surgery, First Affiliated Hospital, College of Medical Sciences, Zhejiang University, Hangzhou 310031, China.
Liang
Ting-bo
TB
Qin
Yun-sheng
YS
Zhang
Min
M
Wang
Wei-lin
WL
Shen
Yan
Y
Wu
Jian
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate