The prognosis of primary gallbladder cancer(PGC) is very poor but patients with PGC whose tumor are an incidental finding at cholecystectomy done for cholecystitis are more fortunate.
The study is a clinical analysis of our surgical experience with PGC at Pusan Gospel Hospital in Korea during 20 years from 1970 to 1989. We had surgically treated 130 PGC patients among 2997 operated biliary diseases. The sex ratio(M : F) was 1
:
1.2
and mean age was 57 years. According to the TNM system by the manual of AJCC(1988): 15 patients(11%) belonged to stage I, 19 patient(15%) stage II, 63 patients(48%) stage III, and 33 patients(25%) stage IV. Accuracy of disgnosis prior to surgery
was
35%, Incidental cancer of the gallbladder(GB) found after simple cholecystectomy for cholecystitis(n=4), GB stone(n=1) and GB polyp(n=1) were t cases.
Rescetion was done in 91 cases and gallstone was found 22 cases(24.2%) among them. Of the redical operations performed, included 6 cases of simple cholecystectomy, 28 cases of curative cholecystectomy, 15 cases of curative cholecystectomy with
wedge
hepatic resection. 2 cases of curative cholecystectomy with right hepatic lobectomy and one case of curative cholecystectomy with panceratoduodenectomy. Thrity day-postoperative deaths were 9 cases(7%). The overall 1-, 2-, 3-, and 5-year survival
rates
were 21%, 14%, 8% and 6% respectively. In radically resected patients, these rates were 37%, 27%, 19%, and 14%, respectively. Almost all of the patients with palliative resection died within one year. Of the 6 incidental cancers of the
gallbladder
on
stage I by AJCC, ace cases are still alive and 4 cases are alive over 5 years.
With this study it is suggested that the incidental cancer of the gallbladder on stage I by AJCC found after simple cholecystectomy for presumed benign cholecystopathy(Stage I : AJCC) has good prognosis even though without subsequent radical
reoperation
and although with radical operation, PGC advanced beyond stage II has poor prognosis. Incidence of associated gall stone was very low in comparison with western reports.
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