Abstract
Experience in the United States of America with the use of radical operations for carcinoma of the gallbladder was reviewed. Four studies using the Nevin clinicopathologic classification were combined for analysis. The 5-year survival rate for patients with stage I disease was 59%; stage II disease, 40%; stage III disease, 9%; stage IV disease, 7%; and stage V disease, 1%. Only one study analyzed the results of surgical procedures according to Nevin staging. No conclusions can be drawn from retrospective studies on the value of operations more radical than simple cholecystectomy. Responses to a questionnaire sent to prominent North American surgeons emphasized the controversial management of patients with this disease.
Résumé
L'expérience américaine de l'exérèse radicale pour cancer de la vésicule biliaire a été étudiée. Quatre études basées sur la classification clinicopathologique de Nevin ont été analysées ensemble. Le taux de survie à 5 ans chez les patients ayant un cancer de stade I était de 59%; de 40% pour les cancers de stade II; de 9% pour les cancers de stade III; de 7% pour les cancers de stade IV; et de 1% pour les cancers de stade V. Une seule étude a analysé les résultats des interventions chirurgicales selon la classification de Nevin. On ne peut tirer aucune conclusion des études rétrospectives sur la valeur des interventions plus radicales ue la cholécystectomie simple. Les résponses à un questionnaire adressé aux meilleurs des chirurgiens de l'Amérique du Nord mettent bien en évidence la controverse sur le traitement des patients atteints de cette maladie.
Resumen
Se revisó la experiencia con el uso de la operación radical para carcinoma de la vesícula biliar en los Estados Unidos. Cuatro estudios que utilizaron la clasificación clinicopatológica de Nevin fueron combinados para el análisis. La tasa de sobrevida a 5 años para pacientes con enfermedad en estado I fue 59%; para enfermedad en estado II, 40%; para enfermedad en estado III, 9%; para enfermedad en estado IV, 7%; y para enfermedad en estado V, 1%. Sólo un estudio analizó los resultados de los procedimientos quirúrgicos de acuerdo a la estadificación de Nevin. No es posible derivar conclusiones, de estudios restrospectivos, sobre el valor de operaciones más radicales que la simple colecistecotomía. Las respuestas a cuestionarios enviados a cirujanos prominentes de los Estados Unidos resaltan la controversia relativa al manejo de pacientes con esta enfermedad.
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Gagner, M., Rossi, R.L. Radical operations for carcinoma of the gallbladder: Present status in North America. World J. Surg. 15, 344–347 (1991). https://doi.org/10.1007/BF01658726
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DOI: https://doi.org/10.1007/BF01658726