PROGNOSTIC FACTORS FOR ADENOCARCINOMA OF THE GALLBLADDER - AN ANALYSIS OF 162 CASES

Carcinoma of the gallbladder is a rare neoplasm and is associated with a dismal prognosis. To analyze the natural history of this disease an d prognostic factors, a large tumor registry database was accessed. Du ring the period 1972 to 1995, 214 patients were entered. Adequate foll ow-up was available on 162 patients, and this group forms the basis of this review. There were 54 males and 108 females with a median age of 62 years. Median follow-up was 7 months. Right upper quadrant abdomin al pain was the most frequent presenting symptom. Fifteen patients had an incidental finding of carcinoma after cholecystectomy. Overall, 5- year survival was 25 per cent, with a median survival time of 9.7 mont hs. Survival was improved for patients with local disease compared wit h those with regional or metastatic disease. One hundred nine patients underwent surgical therapy. Complete resection was possible in 36 pat ients, whereas 44 patients had residual disease. Median survival time for patients with no residual disease was 67.2 months, whereas those f or patients with microscopic residual tumor and gross residual tumor w ere 8.9 and 3.8 months, respectively (P < 0.000001). Gallbladder cance r is often diagnosed at an advanced stage and is associated with a poo r prognosis. In patients with localized disease, surgical treatment pr ovides the opportunity for long-term survival only when a complete res ection can be performed. Prognosis for patients with microscopic resid ual and gross residual disease is similar.