Abstract
Introduction
Gallbladder cancer is the most common malignant tumour of the biliary system with an extraordinarily poor prognosis. In this study, we retrospectively evaluated forty-two patients with histologically proven gallbladder cancer.
Patients and methods
Estimated survival rates were calculated by the Kaplan–Meier method, and differences were assessed using the logrank test. The GKR (combined registry of cancer) and demographic data were used to gain information on community cancer statistics.
Results
In this study, patients with metastases showed poorer survival rates. Furthermore, the survival was significantly better in patients with R0 resections, smaller tumour sizes and without lymph node infiltration. T stage, M stage and R stage were independent prognostic parameters. Sex and age had no significant effect on survival. Also, we found that patients with incidental gallbladder cancer and those with cholecystolithiasis showed significantly better survival rates. Demographic analyses of the study group confirmed a high coverage of our institution for incident cases in our catchment area and no significant regional deviations from the expected incidence of gallbladder cancer.
Conclusion
Despite differences in the incidence in different geographical areas, gallbladder cancer appears to be fairly normally distributed in Western Pomerania, a predominantly rural area of Northeastern Germany. Coverage of incident cases in our catchment area was high. T stage, M stage and R stage were independent prognostic factors in our study. We conclude that, whenever possible, an R0 resection should be the surgical goal in all patients staged resectable before surgery, but heroic resections in patients with highly advanced cancer disease or severe accompanying non-tumour diseases are not warranted.
Similar content being viewed by others
References
Lai CH, Lau WY (2008) Gallbladder cancer—a comprehensive review. Surgeon 6:101–110
Puhalla H, Bareck E, Scheithauer W et al (2002) Therapy of gallbladder carcinoma. Experience of a central hospital. Chirurg 73:50–56
Lemrow SM, Perdue DG, Stewart SL et al (2008) Gallbladder cancer incidence among American Indians and Alaska Natives, US, 1999–2004. Cancer 113:1266–1273
Shrikhande SV, Barreto SG, Singh S et al (2010) Cholelithiasis in gallbladder cancer: coincidence, cofactor, or cause! Eur J Surg Oncol 36:514–519
Miller G, Jarnagin WR (2008) Gallbladder carcinoma. Eur J Surg Oncol 34:306–312
Mekeel KL, Hemming AW (2007) Surgical management of gallbladder carcinoma: a review. J Gastrointest Surg 11:1188–1193
Kondo S, Nimura Y, Kamiya J et al (2002) Mode of tumor spread and surgical strategy in gallbladder carcinoma. Langenbecks Arch Surg 387:222–228
Orth K, Beger HG (2000) Gallbladder carcinoma and surgical treatment. Langenbecks Arch Surg 385:501–508
Goetze TO, Paolucci V (2010) Adequate extent in radical re-resection of incidental gallbladder carcinoma: analysis of the German registry. Surg Endosc. doi:10.1007/s00464-010-0914-4
Sobin LH, Gospodarowicz MK, Wittekind C (2009) TNM Classification of Malignant Tumours, 7th edition, John Wiley and Sons, New York
Jayaraman S, Jarnagin WR (2010) Management of gallbladder cancer. Gastroenterol Clin North Am 39:331–342
Kiran RP, Pokala N, Dudrick SJ (2007) Incidence pattern and survival for gallbladder cancer over three decades—an analysis of 10301 patients. Ann Surg Oncol 14:827–832
Schauer RJ, Meyer G, Baretton G et al (2001) Prognostic factors and long-term results after surgery for gallbladder carcinoma: a retrospective study of 127 patients. Langenbecks Arch Surg 386:110–117
Bartlett DL, Fong Y, Fortner JG et al (1996) Long-term results after resection for gallbladder cancer. Implications for staging and management. Ann Surg 224:639–646
Shimada H, Endo I, Fujii Y et al (2000) Appraisal of surgical resection of gallbladder cancer with special reference to lymph node dissection. Langenbecks Arch Surg 385:509–514
Ito H, Matros E, Brooks DC et al (2004) Treatment outcomes associated with surgery for gallbladder cancer: a 20-year experience. J Gastrointest Surg 8:183–190
Wakabayashi H, Ishimura K, Hashimoto N et al (2004) Analysis of prognostic factors after surgery for stage III and IV gallbladder cancer. Eur J Surg Oncol 30:842–846
Tazuma S, Kajiyama G (2001) Carcinogenesis of malignant lesions of the gall bladder. The impact of chronic inflammation and gallstones. Langenbecks Arch Surg 386:224–229
Foster JM, Hoshi H, Gibbs JF et al (2007) Gallbladder cancer: defining the indications for primary radical resection and radical re-resection. Ann Surg Oncol 14:833–840
Lazcano-Ponce EC, Miquel JF, Munoz N et al (2001) Epidemiology and molecular pathology of gallbladder cancer. CA Cancer J Clin 51:349–364
Randi G, Franceschi S, La Vecchia C (2006) Gallbladder cancer worldwide: geographical distribution and risk factors. Int J Cancer 118:1591–1602
Conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Additional information
Katharina Cziupka, Lars Ivo Partecke, Wolfram von Bernstorff, and Albrecht Stier contributed equally and share first/senior authorship.
Rights and permissions
About this article
Cite this article
Cziupka, K., Partecke, L.I., Mirow, L. et al. Outcomes and prognostic factors in gallbladder cancer: a single-centre experience. Langenbecks Arch Surg 397, 899–907 (2012). https://doi.org/10.1007/s00423-012-0950-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00423-012-0950-8