title: Outcomes and prognostic factors in gallbladder cancer: a single-centre experience.
abstract: BACKGROUND
  Gallbladder cancer is the most common malignant tumour of the biliary system with an extraordinarily poor prognosis. In this study, we retrospectively evaluated forty-two patients with histologically proven gallbladder cancer.
  
  
  METHODS
  Estimated survival rates were calculated by the Kaplan-Meier method, and differences were assessed using the logrank test. The GKR (combined registry of cancer) and demographic data were used to gain information on community cancer statistics.
  
  
  RESULTS
  In this study, patients with metastases showed poorer survival rates. Furthermore, the survival was significantly better in patients with R0 resections, smaller tumour sizes and without lymph node infiltration. T stage, M stage and R stage were independent prognostic parameters. Sex and age had no significant effect on survival. Also, we found that patients with incidental gallbladder cancer and those with cholecystolithiasis showed significantly better survival rates. Demographic analyses of the study group confirmed a high coverage of our institution for incident cases in our catchment area and no significant regional deviations from the expected incidence of gallbladder cancer.
  
  
  CONCLUSIONS
  Despite differences in the incidence in different geographical areas, gallbladder cancer appears to be fairly normally distributed in Western Pomerania, a predominantly rural area of Northeastern Germany. Coverage of incident cases in our catchment area was high. T stage, M stage and R stage were independent prognostic factors in our study. We conclude that, whenever possible, an R0 resection should be the surgical goal in all patients staged resectable before surgery, but heroic resections in patients with highly advanced cancer disease or severe accompanying non-tumour diseases are not warranted.
authors.affiliation: Department of General, Visceral, Thoracic and Vascular Surgery, University Medicine Greifswald, Ferdinand-Sauerbruch-Strasse, Greifswald, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Cziupka
authors.forename: Lars Ivo
authors.initials: LI
authors.lastname: Partecke
authors.forename: Lutz
authors.initials: L
authors.lastname: Mirow
authors.forename: Claus-Dieter
authors.initials: CD
authors.lastname: Heidecke
authors.forename: Christian
authors.initials: C
authors.lastname: Emde
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hoffmann
authors.forename: Ulrike
authors.initials: U
authors.lastname: Siewert
authors.forename: Neeltje
authors.initials: N
authors.lastname: van den Berg
authors.forename: Wolfram
authors.initials: W
authors.lastname: von Bernstorff
authors.forename: Albrecht
authors.initials: A
authors.lastname: Stier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D002277:Carcinoma / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D002763:Cholecystectomy / Q000379:methods*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005706:Gallbladder Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000601:surgery; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome