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Does Radical Resection Improve Outcome?

John H. Donohue, MD; David M. Nagorney, MD; Clive S. Grant, MD; Kenichi Tsushima, MD; Duane M. Ilstrup, MS; Martin A. Adson, MD

Arch Surg. 1990;125(2):237-241.

Abstract
• 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.

(Arch Surg. 1990;125:237-241)

Author Affiliations
From the Departments of Surgery (Drs Donohue, Nagorney, Grant, Tsushima, and Adson) and Biostatistics (Mr Ilstrup), Mayo Clinic, Rochester, Minn.

Footnotes
Accepted for publication September 14, 1989.

Read before the annual meeting of the Society of Surgical Oncology, San Francisco, Calif, May 24, 1989.

Reprint requests to Mayo Clinic, 200 First St SW, Rochester, MN 55905 (Dr Nagorney).

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