title: Evaluation of surgical resection for gallbladder carcinoma at a Japanese cancer institute.
abstract: OBJECTIVE
  Surgical resection is a radical treatment option for gallbladder carcinoma (GBC); however, it is still difficult to cure and patient prognosis is poor. An assessment of the surgical results and chemotherapy options may elucidate effective treatments.
  
  
  METHODS
  We retrospectively examined the demographics, surgical records and outcome in 33 patients with GBC undergoing surgical resection.
  
  
  RESULTS
  Postoperative cancer recurrence was observed in 36% of patients. Mean cancer-free survival time was 84 months and 3-year cancer-free survival rate was 70% Mean overall survival time was 96 months and 5-year overall survival rate was 52%. The 3-year cancer-free survival and the 5-year overall survival were significantly different between the final tumor stages (p<0.001). Higher CEA and CA19- 9 level were significantly related to poor overall survival (p<0.05). Macroscopically, papillary type tumor showed significantly better overall survival compared to nodular or flat types (p<0.05). Degree of invasion, node metastasis, moderate or poor differentiation, vascular or perineural invasion and invasion of the liver or hepatoduodenal ligament were significantly associated with poor overall survival (p<0.05). A cancerfree margin at the hepatic cut end and dissected periductal structures showed a significantly poor prognosis (p<0.05). The overall survival in final curability A was significantly associated with better curability than B or C (p<0.05).
  
  
  CONCLUSIONS
  Radically extended surgical resection for GBC is necessary to obtain improved patient survival and new adjuvant chemotherapy would be expected to improve results after surgery.
authors: Division of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. a-nanasm@nagasaki-u.ac.jp
authors: Atsushi
authors: A
authors: Nanashima
authors: Syuuichi
authors: S
authors: Tobinaga
authors: Takafumi
authors: T
authors: Abo
authors: Tomohito
authors: T
authors: Morisaki
authors: Ryouhei
authors: R
authors: Uehara
authors: Hiroaki
authors: H
authors: Takeshita
authors: Takashi
authors: T
authors: Nonaka
authors: Shigekazu
authors: S
authors: Hidaka
authors: Fuminao
authors: F
authors: Takeshima
authors: Ken
authors: K
authors: Ohnita
authors: Hajime
authors: H
authors: Isomoto
authors: Masaki
authors: M
authors: Kunizaki
authors: Terumitsu
authors: T
authors: Sawai
authors: Kazuhiko
authors: K
authors: Nakao
authors: Takeshi
authors: T
authors: Nagayasu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018395:CA-19-9 Antigen / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D002277:Carcinoma / Q000097:blood / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D002454:Cell Differentiation; D017024:Chemotherapy, Adjuvant; D002763:Cholecystectomy / Q000009:adverse effects / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D005706:Gallbladder Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007564:Japan; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen