A Clinical Study of Prognostic Factors in Gallbladder Cancer.
- Author:
Seok Byoung LIM
1
;
Ki Hwan KIM
;
Sun Whe KIM
;
Yong Bum YOON
;
Yong Hyun PARK
Author Information
1. Departments of Surgery, College of Medicine, Seoul National University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Gallbladder carcinoma;
Survival rate;
Prognosis
- MeSH:
Abdominal Pain;
Adenocarcinoma;
Diagnosis;
Digestive System;
Early Diagnosis;
Gallbladder Neoplasms*;
Gallbladder*;
Humans;
Lymphatic Metastasis;
Mortality;
Nausea;
Prognosis;
Retrospective Studies;
Sex Ratio;
Survival Rate;
Vomiting;
Weight Loss
- From:Journal of the Korean Surgical Society
1998;55(1):120-131
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Cancer of the gallbladder, the fifth most common malignant disease of the digestive system, is almost always associated with an unfavorable prognosis, and the clinical outcome has not improved much during the past couple of decades. This study was intended to analyze our surgical experience and to evaluate the prognostic significance of clinicopathologic factors for primary carcinoma of the gallbladder. We retrospectively reviewed the data of 113 patients with gallbladder carcinomas operated on over a period of 9 years from Jan. 1987 to Dec. 1995 at our surgical Department. In addition, a comparison with an analysis of cases from the last 10 years and a review of the disease are presented. The sex ratio (M : ) was 1.02 : , and mean age was 58.9 years. The most common presenting complaint was abdominal pain, followed by nausea and vomiting, and weight loss. An accurate preoperative diagnosis was made in 57.5% of the patients. The most common histologic type was adenocarcinoma (85.8%). A curative resection was done in 57 cases (51.4%). The overall 5-year survival rate was 21.1%, and in curative resected patients, the rates according to AJCC stage I, II, and III were 100%, 42.3%, and 14.6%, respectively. In the curative resected group, a univariate logrank analysis of 16 clinicopathologic factors showed that depth of invasion, macroscopic finding, histologic grading, lymphatic metastasis, and tumor location were significant prognostic factors. Multivariate Cox-regression analysis of these five profound factors demonstrated that only the depth of invasion was an independent variable. An analysis of survival rates according to the significant depth of invasion was done, and the 5-year survival rates for T1, T2, T3, and T4 were 72.4%, 30.2%, 8.7%, and 0%, respectively. When our data were compared with those of a previous study, the rate of curative resection and the operative mortality in our study were found to be improved over those of the earlier study. However, no progress has been made in survival during the last 10 years. In conclusion, long-term survival may be achieved by early diagnosis with a curative, radical operation, and the establishment of adjuvant therapy is required for advanced T-lesions of the gallbladder carcinoma.
