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Surgical outcome and prognostic factors in patients with gallbladder carcinoma.

Hong EK, Kim KK, Lee JN, Lee WK, Chung M, Kim YS, Park YH - Korean J Hepatobiliary Pancreat Surg (2014)

Bottom Line: Gallbladder carcinoma is usually associated with an unfavorable prognosis, and the clinical outcome has not improved much.Multivariate analysis revealed that curative resection, preoperative CA19-9, T-stage, N-stage and differentiation of histology were independently significant prognostic factors.Radical resection improves survival for patients with localized gallbladder carcinoma and can help to access exact prognosis and treatments.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea.

ABSTRACT

Backgrounds/aims: Gallbladder carcinoma is usually associated with an unfavorable prognosis, and the clinical outcome has not improved much. This study was conducted to evaluate outcomes with gallbladder carcinoma according to the type of surgery performed, and the prognostic factors for survival.

Methods: One hundred and six patients with gallbladder carcinoma, who underwent surgery for the purpose of curative resection between January 1999 and June 2012 were reviewed retrospectively.

Results: Out of 106 patients, curative resection was achieved in 75 (70.8%). The cumulative 1-, 2- and 5-year survival rates of the gallbladder carcinoma patients were 93.4%, 80.9% and 63.0%, respectively. Radical resections, including extended cholecystectomy, were more beneficial for long term survival of patients. The 5-year survival rate in patients who underwent curative resection (56.9%) was significantly higher than in those who underwent palliative resection (0%, p=0.000). Multivariate analysis revealed that curative resection, preoperative CA19-9, T-stage, N-stage and differentiation of histology were independently significant prognostic factors.

Conclusions: Curative resection and early detection of patients with gallbladder carcinoma were the most important factors for long term survival. Radical resection improves survival for patients with localized gallbladder carcinoma and can help to access exact prognosis and treatments.

No MeSH data available.


Related in: MedlinePlus

Cumulative survival curves according to N-stages (p<0.05).
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Figure 5: Cumulative survival curves according to N-stages (p<0.05).

Mentions: In the pathological findings, 44 patients showed moderate differentiation (41.5%), which was the largest proportion. Patients with poor differentiation had significantly low survival rates. Regarding the T stages, which represent the invasion of the cancer to the gallbladder wall, T3 stage was found in 41 patients (38.7%). This stage was most common, followed by the T2 stage with 36 patients (34%), T1b stage with 10 patients, and the T1a stage with 8 patients. A total of 43 patients (40.6%) had metastasis in their lymph nodes, with 1 patient in whom the tumor invaded muscle in the T1b stage. Out of 36 patients in the T2 stage, 8 (22.2%) had lymph node metastasis (Table 4). The 5-year survival rates in T1a, T1b, T2, T3, and T4 stages were 100%, 91.30%, 42.0%, 14.6%, and 0%, respectively, (p=0.0032), showing statistically significant differences in survival (Fig. 4). The 1-, 3-, and 5-year survival rates in the patient group without lymph node metastasis were 85.3%, 69.7%, and 55.0%, respectively, while the 1-, 3-, and 5-year survival rates of the patient group with N1 metastasis were 75.6%, 29.7%, and 11.9%, indicating that the survival rates of the patient group with lymph node metastasis were significantly low (p=0.045) (Fig. 5). Both patients with N2 lymph node metastasis died within 1 year.


Surgical outcome and prognostic factors in patients with gallbladder carcinoma.

Hong EK, Kim KK, Lee JN, Lee WK, Chung M, Kim YS, Park YH - Korean J Hepatobiliary Pancreat Surg (2014)

Cumulative survival curves according to N-stages (p<0.05).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4492352&req=5

Figure 5: Cumulative survival curves according to N-stages (p<0.05).
Mentions: In the pathological findings, 44 patients showed moderate differentiation (41.5%), which was the largest proportion. Patients with poor differentiation had significantly low survival rates. Regarding the T stages, which represent the invasion of the cancer to the gallbladder wall, T3 stage was found in 41 patients (38.7%). This stage was most common, followed by the T2 stage with 36 patients (34%), T1b stage with 10 patients, and the T1a stage with 8 patients. A total of 43 patients (40.6%) had metastasis in their lymph nodes, with 1 patient in whom the tumor invaded muscle in the T1b stage. Out of 36 patients in the T2 stage, 8 (22.2%) had lymph node metastasis (Table 4). The 5-year survival rates in T1a, T1b, T2, T3, and T4 stages were 100%, 91.30%, 42.0%, 14.6%, and 0%, respectively, (p=0.0032), showing statistically significant differences in survival (Fig. 4). The 1-, 3-, and 5-year survival rates in the patient group without lymph node metastasis were 85.3%, 69.7%, and 55.0%, respectively, while the 1-, 3-, and 5-year survival rates of the patient group with N1 metastasis were 75.6%, 29.7%, and 11.9%, indicating that the survival rates of the patient group with lymph node metastasis were significantly low (p=0.045) (Fig. 5). Both patients with N2 lymph node metastasis died within 1 year.

Bottom Line: Gallbladder carcinoma is usually associated with an unfavorable prognosis, and the clinical outcome has not improved much.Multivariate analysis revealed that curative resection, preoperative CA19-9, T-stage, N-stage and differentiation of histology were independently significant prognostic factors.Radical resection improves survival for patients with localized gallbladder carcinoma and can help to access exact prognosis and treatments.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Gachon University Gil Medical Center, Incheon, Korea.

ABSTRACT

Backgrounds/aims: Gallbladder carcinoma is usually associated with an unfavorable prognosis, and the clinical outcome has not improved much. This study was conducted to evaluate outcomes with gallbladder carcinoma according to the type of surgery performed, and the prognostic factors for survival.

Methods: One hundred and six patients with gallbladder carcinoma, who underwent surgery for the purpose of curative resection between January 1999 and June 2012 were reviewed retrospectively.

Results: Out of 106 patients, curative resection was achieved in 75 (70.8%). The cumulative 1-, 2- and 5-year survival rates of the gallbladder carcinoma patients were 93.4%, 80.9% and 63.0%, respectively. Radical resections, including extended cholecystectomy, were more beneficial for long term survival of patients. The 5-year survival rate in patients who underwent curative resection (56.9%) was significantly higher than in those who underwent palliative resection (0%, p=0.000). Multivariate analysis revealed that curative resection, preoperative CA19-9, T-stage, N-stage and differentiation of histology were independently significant prognostic factors.

Conclusions: Curative resection and early detection of patients with gallbladder carcinoma were the most important factors for long term survival. Radical resection improves survival for patients with localized gallbladder carcinoma and can help to access exact prognosis and treatments.

No MeSH data available.


Related in: MedlinePlus