This study was conducted to evaluate the benefit of an aggressive approach to gallblader cancer on long-term survival. We analyzed the results of operating on 70 patients who underwent operation for gallbladder cancer in our hospital, from 1985
to
1994.
29 of the patients were men and 41 were women, a sex ratio of 1 to 1.4. The age distribution were 27 to 91 years with a mean age of 57.4 years. The patients were grouped according to the staging system of Nevin et al. -8 stage I, 8 stage II, 7
stage
III, 9 stage IV and 38 stage V patients. For the entire group of 70 patients cumulative survival rate was 45.8% at 2years and 38.4% at 5 years. Of 23 patients(32.9%) with tumor limited to the gallbladder wall (Group 1: stage I, II, and III), 14
patients
treated with cholecystectomy, 3 patients treated with cholecystectomy and I-tube choledochostomy, 3 patients treated with cholecystectomy and hepaticojejunostomy, and 3 patients treated with radical cholecystectomy. The cumulative survival rate
of
this
group was 84.5% at 5 yerars. Especilally 3 patient with radical cholecystectomy has good prognosis (36 Mo live, 55 Mo live, 96 Mo die of other disease) Of 47 patients with advanced disease (Group 2: stage IV and V), 6 patients underwent
exploratory
laparotomy only, 30 patients underwent palliative surgery, and 11 patients were treated with curative surgery (5 radical cholecystectomy, 1 radical cholecystectomy with right lobectomy, 3 radical cholecystectomy with segmental resection of colon,
2
hepatopancreatoduodenectomy). The cumulative survival rate of this group was 19.9% at 2 years and 9.9%. at 5 years. Patients who underwent exploratory laparotomy, no one was alive for more than 4 months. Patients who underwent with palliative
surgery
were all dead within 19 months. In patients who underwent with curative surgery, the cumulative survival rate was 72.7% at 1 year, and 4 patient were alive and tumor-free for more than 2 years. From our expe-rience we believe that longer survival
may be
achieved by aggressive surgery if it is suitably indicated.
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