HEPATO-GASTROENTEROLOGY 59, 118, 1717 - 1721 (2012).
Evaluation of Surgical Resection for Gallbladder Carcinoma at a Japanese Cancer Institute


Atsushi Nanashima , Syuuichi Tobinaga , Takafumi Abo , Tomohito Morisaki , Ryouhei Uehara , Hiroaki Takeshita , Takashi Nonaka , Shigekazu Hidaka , Fuminao Takeshima , Ken Ohnita , Hajime Isomoto , Masaki Kunizaki , Terumitsu Sawai , Kazuhiko Nakao , Takeshi Nagayasu




Background/Aims: Surgical resection is a radical treatment option for gallbladder carcinoma (GBC); however, it is still difficult to cure and patient prognosis is poor. An assessment of the surgical results and chemotherapy options may elucidate effective treatments. Methodology: We retrospectively examined the demographics, surgical records and outcome in 33 patients with GBC undergoing surgical resection. Results: Postoperative cancer recurrence was observed in 36% of patients. Mean cancer-free survival time was 84 months and 3-year cancer-free survival rate was 70% Mean overall survival time was 96 months and 5-year overall survival rate was 52%. The 3-year cancer-free survival and the 5-year overall survival were significantly different between the final tumor stages (p<0.001). Higher CEA and CA199 level were significantly related to poor overall sur-vival (p<0.05). Macroscopically, papillary type tumor showed significantly better overall survival compared to nodular or flat types (p<0.05). Degree of invasion, node metastasis, moderate or poor differentiation, vascular or perineural invasion and invasion of the liver or hepatoduodenal ligament were significantly associated with poor overall survival (p<0.05). A cancer-free margin at the hepatic cut end and dissected periductal structures showed a significantly poor prognosis (p<0.05). The overall survival in final curability A was significantly associated with better curability than B or C (p<0.05). Conclusions: Radically extended surgical resection for GBC is necessary to obtain improved patient survival and new adjuvant chemotherapy would be expected to improve results after surgery.