Gallbladder cancer: A review of 39 cases

Gallbladder cancer, the commonest biliary tract malignancy, has not received much attention, and not much progress has been made in its management. We reviewed the clinical manifestations and outcome of gallbladder cancer, analyzed the prognostic factors of this disease, and tried to achieve an optimal treatment plan. From August, 1986 to April, 1998, 39 patients with gallbladder cancer treated at our hospital are included in this study. Twenty-four patients underwent cholecystectomy and the other fifteen underwent combined resection. The post-operative outcomes and possible related prognostic factors were reviewed and analyzed. Twenty-eight patients were females and eleven patients were males. The follow-up period ranged from 1-128 (32.2 +/- 37.8 [mean +/- SD]) months. The 2-year survival is 28.2%. RUQ pain/Epigastralgia was the most common clinically presented symptom (82.1%). Gallbladder cancer was diagnosed pre-operatively only in 8 patients (20.5%). The age, "T" factors of the TNM staging system and Nevin staging system were significant prognostic factors in the univariate analysis (P<0.05). But only "T" factor of the TNM staging system has significant risk ratios (P<0.001). T factor of TNM staging system is the only significant prognostic factor of gallbladder cancer. Earlier stage gallbladder cancers (T1 and T2) treated by extended cholecystectomy usually carry favorable prognosis. As to stage of more than T3, the prognosis is poor no matter how the patient was treated surgically.