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Eur J Surg Oncol. 2013 Jun;39(6):548-53. doi: 10.1016/j.ejso.2013.02.010. Epub 2013 Mar 21.

Carcinoma of the gallbladder: patterns of presentation, prognostic factors and survival rate. An 11-year single centre experience.

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  • 1Hopital Saint Luc-CHUM, Service de chirurgie hépatobiliaire et pancréatique, Université de Montréal, Canada.

Abstract

BACKGROUND:

This report examines the patterns of presentation, prognostic factors and survival rate of all patients with gallbladder cancer (GBC) evaluated at our tertiary academic hospital over an 11-year period.

METHODS:

A retrospective review of a prospectively collected database of all patients with GBC presenting between January 1998 and December 2008 was performed.

RESULTS:

102 GBC-patients were included: 69 women and 33 men (median age: 65,5 years). Forty-five patients presented with incidental gallbladder cancer (IGC) and 57 with nonincidental cancer (NIGC). Curative surgery rate was 84.4% for IGC and 29.8% for NIGC (p < 0.001). Five-year actuarial survival rate was 63.2% for patients with curative intent surgery and 0% for patients with palliative approach. Patients with IGC had a longer survival rate compared to patients with NIGC (median: 25.8 vs. 4.4 months, p < 0.0001). For patients with radical resection (42 patients), there was no difference between IGC and NIGC. The incidence of liver involvement was respectively 0%, 20.8%, 58.3%, 100% for pT1, pT2, pT3 and pT4 tumors. Univariate analysis showed that survival rate was significantly affected by perineural invasion, T, N and M-stage, R0 resection, liver involvement, CA-19.9. In multivariate analysis, liver involvement was the only independent factor.

CONCLUSIONS:

Majority of patients with a potentially curable disease had IGC. Almost 80% of patients with NIGC presented with unresectable disease. For patients who underwent resection with curative intent, actuarial 5-year survival was 63.2%. Liver involvement was the only independent prognostic factor. All patients with IGC and a pT2 or more advanced T stage should undergo a second radical resection.

Copyright © 2013 Elsevier Ltd. All rights reserved.

PMID:
23522952
[PubMed - indexed for MEDLINE]
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