title: Unsuspected gallbladder cancer: a clinical retrospective study.
abstract: BACKGROUND
  The morbidity of unsuspected gallbladder carcinoma (UGC) has increased. This study was aimed to explore the factors which may influence the therapeutic strategies and prognosis of UCG. Additionally, long-term prognosis of laparoscopic and open surgeries of UGC was comparatively investigated.
  
  
  METHODS
  Thirty-eight cases of UGC were enrolled in this study. Statistical analysis of survival was performed using the Kaplan-Meier test and the results were examined using the log-rank test.
  
  
  RESULTS
  The morbidity of UGC was 0.43 %. The cancer stagings were: pT1a (one), pT1b (11), pT2 (14), pT3 (10), pT3N1 (one), and pT4 (one). The median lifespan of the entire cohort was 20.0 ± 6.5 months, one-year survival rate was 44 %, and five-year survival rate was 11 %. One-year recurrence- free survival rate was 44 % and three-year recurrence- free survival rate was 0 %. Twenty-eight patients sustained cancer recurrence and three patients sustained port-site cancer recurrence. The cancer staging (P < 0.01) and radical resection (P < 0.01) were independent factors for both overall and recurrence-free survival. Radical resection improved the prognosis of the patients with pT2 stage UGC (P < 0.05), but no significant impact on the prognosis of the patients with pT1b (P = 0.362) or pT3 stage (P = 0.221) UGC. Survival rates were not significantly affected by the first operation no matter it was laparoscopic surgery or open surgery (P = 0.12).
  
  
  CONCLUSIONS
  Radical resection surgery is recommended in pT2 stage UGC. There is no difference for the long-term prognosis between laparoscopic surgery (cholecystectomy) and open surgery of UCG.
authors.affiliation: Department of Hepatobiliary and Pancreas Surgery, The First Affiliated Hospital, Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi, China. luyi169@126.com.
authors.forename: Liangshuo
authors.initials: L
authors.lastname: Hu
authors.forename: Bo
authors.initials: B
authors.lastname: Wang
authors.forename: Xuemin
authors.initials: X
authors.lastname: Liu
authors.forename: Yi
authors.initials: Y
authors.lastname: Lv
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic; D002764:Cholecystitis / Q000175:diagnosis / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005706:Gallbladder Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D033162:Incidental Findings; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology*; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D011127:Polyps / Q000175:diagnosis / Q000601:surgery; D012189:Retrospective Studies; D015996:Survival Rate