Surgical Outcomes and Prognostic Factors of Primary Gallbladder Carcinoma

Jung, Mi Ran; Hur, Young Hoe; Koh, Yang Seok; Kim, Jung Chul; Cho, Chol Kyoon; Kim, Hyun Jong

Abstract

PURPOSE: Even with recent advances of diagnostic tools and therapeutic strategies, the prognosis of gallbladder cancers remains poor. The clinical outcome has not improved much over the past couple of decades. This study analyzed our surgical results to evaluate the prognostic factors associated with survival after surgery in patients with gallbladder malignancies.
METHODS
Retrospective review of 69 patients with gallbladder carcinomas operated on at our surgical department over a period of 9 years from May 1995 to April 2004.
RESULTS
The overall 5-year survival rate was 45.9%, 3-year survival rate 52.8% and 1-year survival rate 72.4%. The 5-year survival rates according to the AJCC stage were 0 100%, Ia 100%, Ib 71.0%, IIa 41.7%, IIb 23.8%, III 50.0%, and IV 11.0% for each. The 5-year survival rates according to the depth of invasion were Tis 100%, T1a 100%, T1b 66.6%, T2 57.1%, T3 36.8%, and T4 22.7%. A univariate analysis of clinicopathologic factors showed that the T stage, N stage, M stage, radical surgery, tumor location, surgical procedure and histological grade were significant prognostic factors. Multivariate Cox-regression analysis of these eight important factors demonstrated that lymph node metastases and the degree of radical surgery were independent variables associated with prognosis.
CONCLUSION
The results of this study showed that lymph node metastases and degree of radical surgery were associated with patient prognosis. Therefore, long-term survival may be achieved by an early diagnosis with curative radical tumor resection.