Long-term results after curative resection for carcinoma of the gallbladder. French University Association for Surgical Research.

BACKGROUND

The surgical management of gallbladder carcinoma is controversial, especially as regards the indications for radical resection. The aim of this study was to evaluate the results of surgical treatment for gallbladder carcinoma with special reference to the extent of its histological spread.

METHODS

Eighty-six patients from 25 French centers underwent resection for cure and were included in this study. They comprised 65 women and 21 men (mean age 65 +/- 21 years). Resection included radical resection in 21 patients (partial hepatectomy, regional lymphadenectomy, and common bile duct resection) and simple cholecystectomy in 65.

RESULTS

There were 3 postoperative deaths (3.5%). The mean follow-up period was 25 +/- 24 months. The overall 5-year actuarial survival rate was 26%. The 5-year actuarial survival rate was 27% for patients who had radical resection. Eight patients with nodal metastasis had a 5-year survival rate of 0%, but the rate for 13 patients without such metastasis was 43% (P <0.05). For patients undergoing simple cholecystectomy, the 5-year actuarial survival rate was 44% for stage I disease, 22% for stage II, and 0% for stage III (P <0.05).

CONCLUSIONS

In patients with stage I gallbladder carcinoma, outcome is good after cholecystectomy only. In stages II to IV, radical resection should only be considered in the absence of regional lymph node metastasis.