Surgical management for carcinoma of the gallbladder: a single-institution experience in 25 years.

[carcinoma of the gallbladder]

Gallbladder carcinoma is rare and associated with dismal outcomes . Radical surgery is the only curative treatment , and options for adjuvant therapy remain limited . This study aimed to determine the factors influencing outcome of treatment in patients with gallbladder carcinoma , and to identify the patients who might benefit from radical surgery and adjuvant therapy .Medical records and follow-up histories of 150 patients with gallbladder carcinoma who had undergone surgery between April 1980 and December 2005 were retrospectively reviewed . The factors predictive for the survival of the patients were identified using multivariate analysis .Surgery for gallbladder cancer was associated with an overall 5 -year survival rate of 26 .2 %. After curative resection (40 % of the patients ), the 5 -year survival rate was 60 .3 %. The patients who underwent R 0 resection had a significantly longer median survival (97 .3 months ) than those who had R 1 /R 2 resection (8 .3 months ) or only laparotomy (3 .7 months ) (P < 0 .0001 ). Univariate analysis showed that resectability , American Joint Committee on Cancer staging , tumor grade , adjuvant therapy , jaundice at presentation , depth of tumor invasion , lymph node involvement , distant metastasis , and carcinoembryonic antigen level were statistically significant predictors for survival . Multivariate analysis revealed American Joint Committee on Cancer staging and resectability were independent prognostic factors for survival . The patients who underwent noncurative resection might benefit from adjuvant therapy (median survival , 12 .4 months vs 7 .2 months , P = 0 .006 ).Favorable survival rate can be achieved after curative resection , even for selected patients with advanced disease . Adjuvant therapy may improve the survival of patients with gallbladder carcinoma .

Diseases
Validation

Diseases presenting "cancer" symptom

achondroplasia

acute rheumatic fever

adrenal incidentaloma

alpha-thalassemia

benign recurrent intrahepatic cholestasis

cadasil

canavan disease

carcinoma of the gallbladder

cholangiocarcinoma

coats disease

congenital adrenal hyperplasia

congenital diaphragmatic hernia

cowden syndrome

cushing syndrome

cutaneous mastocytosis

dedifferentiated liposarcoma

dystrophic epidermolysis bullosa

epidermolysis bullosa simplex

erdheim-chester disease

erythropoietic protoporphyria

esophageal adenocarcinoma

esophageal carcinoma

esophageal squamous cell carcinoma

familial hypocalciuric hypercalcemia

familial mediterranean fever

gm1 gangliosidosis

heparin-induced thrombocytopenia

hereditary cerebral hemorrhage with amyloidosis

hirschsprung disease

hodgkin lymphoma, classical

inclusion body myositis

junctional epidermolysis bullosa

kabuki syndrome

kallmann syndrome

kindler syndrome

lamellar ichthyosis

liposarcoma

locked-in syndrome

lymphangioleiomyomatosis

monosomy 21

neuralgic amyotrophy

oculocutaneous albinism

oligodontia

oral submucous fibrosis

papillon-lefèvre syndrome

pendred syndrome

pleomorphic liposarcoma

primary effusion lymphoma

proteus syndrome

pyomyositis

pyruvate dehydrogenase deficiency

severe combined immunodeficiency

sneddon syndrome

systemic capillary leak syndrome

triple a syndrome

von hippel-lindau disease

waldenström macroglobulinemia

well-differentiated liposarcoma

werner syndrome

wiskott-aldrich syndrome

wolf-hirschhorn syndrome

x-linked adrenoleukodystrophy

This symptom has already been validated