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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
"independent prognostic factors"
symptom
carcinoma of the gallbladder
cholangiocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
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