Carcinoma of the gallbladder. Does radical resection improve outcome?

J. H. Donohue, D. M. Nagorney, C. S. Grant, K. Tsushima, D. M. Ilstrup and M. A. Adson
Department of Surgery, Mayo Clinic, Rochester, Minn 55905.

The records of 111 patients with gallbladder carcinoma operatively treated between 1972 and 1984 were retrospectively reviewed. Fifty-seven percent of patients had distant metastases; another 16% had nodal metastases without distant disease. Median survival was 0.5 years, and 5-year survival was 13%. Clinical jaundice, tumor stage, and tumor grade were all predictive of patient outcome. DNA ploidy, measured in 70 patients, was not a prognostic indicator. In 36% of patients, cholecystectomy (20%) or radical cholecystectomy (16%), which included adjacent liver and regional lymph node resection, was potentially curative. Median survival for patients undergoing radical procedures was 3.6 years, and survival was 0.8 years for patients following cholecystectomy. The 5-year survival rates were comparable (33% vs 32%). While radical cholecystectomy may benefit individual patients and can be accomplished with low morbidity, there was no overall survival advantage compared with cholecystectomy.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

A New Scoring System for Gallbladder Cancer (Aiding Treatment Algorithm): An Analysis of 335 Patients
Shukla et al.
Ann. Surg. Oncol. 2008;15:3132-3137.
ABSTRACT | FULL TEXT  

Analysis of Enhancement Pattern of Flat Gallbladder Wall Thickening on MDCT to Differentiate Gallbladder Cancer from Cholecystitis
Kim et al.
Am. J. Roentgenol. 2008;191:765-771.
ABSTRACT | FULL TEXT  

Biliary Obstruction in Gall Bladder Cancer Is Not Sine Qua Non of Inoperability
Agarwal et al.
Ann. Surg. Oncol. 2007;14:2831-2837.
ABSTRACT | FULL TEXT  

Gallbladder Cancer: Defining the Indications for Primary Radical Resection and Radical Re-resection
Foster et al.
Ann. Surg. Oncol. 2007;14:833-840.
ABSTRACT | FULL TEXT  

Expression of UDP-N-Acetyl-{alpha}-D-Galactosamine-Polypeptide N-Acetylgalactosaminyltransferase Isozyme 3 in the Subserosal Layer Correlates with Postsurgical Survival of Pathological Tumor Stage 2 Carcinoma of the Gallbladder
Miyahara et al.
Clin. Cancer Res. 2004;10:2090-2099.
ABSTRACT | FULL TEXT  

Jaundice Predicts Advanced Disease and Early Mortality in Patients With Gallbladder Cancer
Hawkins et al.
Ann. Surg. Oncol. 2004;11:310-315.
ABSTRACT | FULL TEXT  

Depth of Subserosal Invasion Predicts Long-Term Survival After Resection in Patients With T2 Gallbladder Carcinoma
Wakai et al.
Ann. Surg. Oncol. 2003;10:447-454.
ABSTRACT | FULL TEXT  

Thymidine Phosphorylase Expression in Gallbladder Adenocarcinomas
Giatromanolaki et al.
INT J SURG PATHOL 2002;10:181-188.
ABSTRACT  

Expressions of Cyclooxygenase-2 and Prostaglandin E-Receptors in Carcinoma of the Gallbladder: Crucial Role of Arachidonate Metabolism in Tumor Growth and Progression
Asano et al.
Clin. Cancer Res. 2002;8:1157-1167.
ABSTRACT | FULL TEXT  

Expression of MUC1 Mucins in the Subserosal Layer Correlates with Postsurgical Prognosis of Pathological Tumor Stage 2 Carcinoma of the Gallbladder
Kawamoto et al.
Clin. Cancer Res. 2001;7:1333-1342.
ABSTRACT | FULL TEXT  

Gallbladder Carcinoma: Radiologic-Pathologic Correlation
Levy et al.
RadioGraphics 2001;21:295-314.
ABSTRACT | FULL TEXT  

The role of cyclooxygenase enzymes in the growth of human gall bladder cancer cells
Grossman et al.
Carcinogenesis 2000;21:1403-1409.
ABSTRACT | FULL TEXT  

Biliary Tract Cancers
de Groen et al.
NEJM 1999;341:1368-1378.
FULL TEXT