Journal of Gastrointestinal Surgery

, Volume 15, Issue 6, pp 1007–1016 | Cite as

Prognostic Factors of Patients with Advanced Gallbladder Carcinoma Following Aggressive Surgical Resection

  • Yoshiaki Murakami
  • Kenichiro Uemura
  • Takeshi Sudo
  • Yasushi Hashimoto
  • Akira Nakashima
  • Naru Kondo
  • Ryutaro Sakabe
  • Hironori Kobayashi
  • Taijiro Sueda
Original Article

Abstract

Background

The prognosis for patients with advanced gallbladder carcinoma is dismal despite aggressive surgical resection. The aim of this study is to determine useful prognostic factors for patients with gallbladder carcinoma following aggressive surgical resection.

Methods

Medical records of 62 patients with gallbladder carcinoma who underwent surgical resection were retrospectively reviewed. Univariate and multivariate models were used to analyze the effect of clinicopathological factors on long-term survival.

Results

According to the UICC staging system, ten (16%), 11 (18%), eight (13%), 16 (25%), nine (15%), and eight patients (13%) were diagnosed with stages I, II, IIIA, IIIB, IVA, and IVB disease, respectively. Partial hepatectomy and pancreatoduodenectomy were performed for 43 (69%) and 11 (18%) patients, respectively. Overall survival rates of all 62 and 41 patients with UICC stages III and IV disease were 71% and 56% at 1 year, 48% and 23% at 3 years, and 48% and 23% at 5 years, respectively (median survival time, 15.8 and 12.7 months, respectively). Multivariate analysis revealed that independent prognostic factors included tumor differentiation (p = 0.006), hepatic invasion (p = 0.002), lymph node metastasis (p = 0.009), and surgical margin status (p = 0.002) for all patients, and adjuvant chemotherapy (p = 0.005), tumor differentiation (p = 0.008), hepatic invasion (p = 0.001), and surgical margin status (p = 0.022) for patients with UICC stages III and IV disease.

Conclusions

R0 resection and adjuvant chemotherapy are significant prognostic factors in advanced gallbladder carcinoma and should be performed to improve survival.

Keywords

Gallbladder carcinoma Prognostic factor R0 resection Adjuvant chemotherapy 

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Copyright information

© The Society for Surgery of the Alimentary Tract 2011

Authors and Affiliations

  • Yoshiaki Murakami
    • 1
  • Kenichiro Uemura
    • 1
  • Takeshi Sudo
    • 1
  • Yasushi Hashimoto
    • 1
  • Akira Nakashima
    • 1
  • Naru Kondo
    • 1
  • Ryutaro Sakabe
    • 1
  • Hironori Kobayashi
    • 1
  • Taijiro Sueda
    • 1
  1. 1.Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical SciencesHiroshima UniversityHiroshimaJapan

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