Dr Xabier de Aretxabala and colleagues studied a series of patients with a potentially curative subserosal gallbladder cancer.
The researchers enrolled 139 patients between 1988 and 2004, who were in the prospective database.
Of these patients, 120 were operated on with an open procedure and the rest with laparoscopic surgery.
The team suspected the diagnosis before cholecystectomy in only 8 patients.
The majority of tumors were adenocarcinoma.
The team reported that 6 patients had an epidermoid tumor, and 1 had a carcinosarcoma.
The researchers noted that 74 patients underwent reoperation, while it was possible to perform an extended cholecystectomy with a curative aim in 70%.
Operative mortality was nil, and operative morbidity was 16%.
| Lymph node metastasis was an independent factor for poor prognosis|
|Journal of Gastrointestinal Surgery|
The research team found lymph node metastases were found in 19 %, while the liver was involved in 13%.
The overall survival rate was 68 %, while in those who underwent resection, the survival rate was 77%.
Through the use of a multivariate analysis, the team found that the presence of lymph node metastasis was an independent factor with respect to prognosis.
Dr de Aretxabala's team concluded, “The feasibility of performing an extended cholecystectomy in patients with gallbladder cancer and invasion of the subserosal layer allows for a good survival rate.”
“The presence of lymph node metastases represents the main poor prognosis factor, and some type of adjuvant therapy should be studied in this particular group.”