Surgical treatment for Nevin stage IV and V gallbladder carcinoma: report of 70 cases.
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.
Xiao
Wei-Dong
WD
Department of Surgery, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China.
Peng
Cheng-Hong
CH
Zhou
Guang-Wen
GW
Wu
Wei-Ding
WD
Shen
Bo-Yong
BY
Yan
Ji-Qi
JQ
Yang
Wei-Ping
WP
Li
Hong-Wei
HW
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