The long-term results of managements in 98 cases of gallbladder carcinomas / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>Carcinoma of the gallbladder is an uncommon, but patients with the disease are associated with a dismal prognosis. The purpose of this study was to analyze the characters, prognostic factors of gallbladder carcinoma and investigate the measures of diagnosis and treatment.</p><p><b>METHODS</b>98 patients admitted into our hospital from January 1992 to July 2000 were followed up, with a mean follow-up time of 478 days (1 - 2,280 days). All statistical analyses were performed with SPSS10.0 statistical package. Survival curves were estimated by the Kaplan-Meier method and differences among groups were tested by the log-rank test. The Cox multivariate analysis was performed to determine prognostic factors on survival.</p><p><b>RESULTS</b>Among 98 patients, 31 with radical resection, 29 with palliative resection, 18 with exploration and 20 with chemo- and/or radiotherapy, The overall 5-year survival rate of the gallbladder carcinoma was 6.67%, The 1-, 3-, and 5-year survival rate following radical resection for gallbladder cancer was 77.29%, 34.37%, 21.48% respectively, The survival rate in radical resection group was remarkably higher than that of the others (P < 0.01). Multivariate analysis revealed that tumor, node, metastases (TNM) stage and therapeutic interventions had significantly higher risk ratios for gallbladder cancer.</p><p><b>CONCLUSIONS</b>With careful patient selection, aggressive resection may help to improve the prognosis, although the disease with ominous reputation. Resection alone is inadequate for a significant improvement in survival, so there is a need to evaluate more effective adjuvant therapy in the form of radiotherapy or newer chemotherapeutic agents. Emphasis to improve the long-term survival should be pay on early diagnosis and early management.</p>