title: Surgical treatment for Nevin stage IV and V gallbladder carcinoma: report of 70 cases.
abstract: BACKGROUND
  The role of aggressive surgery for end-stage gallbladder carcinoma is controversial. This retrospective study was designed to evaluate the outcome of surgical treatment for Nevin stage IV and V gallbladder carcinoma at a single institution.
  
  
  METHODS
  A retrospective analysis was made on 70 patients with Nevin stage IV and V gallbladder carcinoma undergoing surgical treatment from January 1993 to June 2004.
  
  
  RESULTS
  There were 22 cases of stage IV and 48 of stage V. Cholecystectomy was performed in 37 cases with a resection rate of 53%, 9 cases received radical resection, 13 extended radical resection, and 15 palliative resection. The curative resection rate was 31% and the morbidity rate was 36%. Postoperative 1-, 3-, 5-year survival rates of curative and palliative resection were 69%, 33%, 8% and 27%, 13%, 0, respectively (P<0.01). The 1- and 3-year survival rates of patients undergoing exploratory laparotomy only were 3% and 0, respectively.
  
  
  CONCLUSIONS
  Nevin stage IV and V gallbladder carcinoma should be treated by aggressive surgery. Curative resection is promising in the improvement of long-term survival rate.
authors.affiliation: Department of Surgery, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China.
authors.forename: Wei-Dong
authors.initials: WD
authors.lastname: Xiao
authors.forename: Cheng-Hong
authors.initials: CH
authors.lastname: Peng
authors.forename: Guang-Wen
authors.initials: GW
authors.lastname: Zhou
authors.forename: Wei-Ding
authors.initials: WD
authors.lastname: Wu
authors.forename: Bo-Yong
authors.initials: BY
authors.lastname: Shen
authors.forename: Ji-Qi
authors.initials: JQ
authors.lastname: Yan
authors.forename: Wei-Ping
authors.initials: WP
authors.lastname: Yang
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Li
mesh_terms: D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D017734:Bile Ducts, Extrahepatic / Q000601:surgery; D002763:Cholecystectomy / Q000379:methods / Q000401:mortality; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008099:Liver / Q000601:surgery; D008197:Lymph Node Excision; D009367:Neoplasm Staging / Q000379:methods*; D010166:Palliative Care; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors