An Aggressive Surgical Approach Leads to Improved Survival in Patients With Gallbladder Cancer
- 1 March 2005
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Annals of Surgery
- Vol. 241 (3), 385-394
- https://doi.org/10.1097/01.sla.0000154118.07704.ef
Abstract
To determine if an aggressive surgical approach, with an increase in R0 resections, has resulted in improved survival for patients with gallbladder cancer. Many physicians express a relatively nihilistic approach to the treatment of gallbladder cancer; consensus among surgeons regarding the indications for a radical surgical approach has not been reached. A retrospective review of all patients with gallbladder cancer admitted during the past 12 years was conducted. Ninety-nine patients were identified. Cases treated during the 12-year period 1990 to 2002 were divided into 2 time-period (TP) cohorts, those treated in the first 6 years (TP1, N = 35) and those treated in the last 6 years (TP2, N = 64). Disease stratification by stage and other demographic features were similar in the 2 time periods. An operation with curative intent was performed on 38 patients. Nine (26%) R0 resections were performed in TP1 and 24 (38%) in TP2. The number of liver resections, as well as the frequency of extrahepatic biliary resections, was greater in TP2 (P < 0.04). In both time periods, an R0 resection was associated with improved survival (P < 0.02 TP1, P < 0.0001 TP2). Overall survival of all patients in TP2 was significantly greater than in TP1 (P < 0.03), with a median survival of 9 months in TP1 and 17 months in TP2. The median 5-year survival in TP1 was 7%, and 35% in TP2. The surgical mortality rate for the entire cohort was 2%, with a 49% morbidity rate. A margin-negative, R0 resection leads to improved survival in patients with gallbladder cancer.Keywords
This publication has 39 references indexed in Scilit:
- Cholecystectomy, Liver Resection, and Pylorus-Preserving Pancreaticoduodenectomy for Gallbladder CancerJournal of Gastrointestinal Surgery, 2002
- Extensive surgery for carcinoma of the gallbladderBritish Journal of Surgery, 2002
- Extensive surgery for carcinoma of the gallbladderBritish Journal of Surgery, 2002
- Regional and para-aortic lymphadenectomy in radical surgery for advanced gallbladder carcinomaBritish Journal of Surgery, 2000
- Treatment of gallbladder cancer by radical resectionBritish Journal of Surgery, 1999
- Outcome of radical surgery for carcinoma of the gallbladder according to the TNM stageSurgery, 1996
- CARCINOMA OF THE GALL‐BLADDER: AN EXPERIENCE AND REVIEW OF THE LITERATUREAnz Journal of Surgery, 1995
- Surgical Treatment of 724 Carcinomas of the Gallbladder Results of the French Surgical Association SurveyAnnals of Surgery, 1994
- Major hepatectomy and pancreatoduodenectomy for advanced carcinoma of the biliary tractBritish Journal of Surgery, 1994
- Radical Surgery for Gallbladder Carcinoma Long-term ResultsAnnals of Surgery, 1992