Skip to main content
Erschienen in: Langenbeck's Archives of Surgery 6/2012

01.08.2012 | Original Article

Outcomes and prognostic factors in gallbladder cancer: a single-centre experience

verfasst von: Katharina Cziupka, Lars Ivo Partecke, Lutz Mirow, Claus-Dieter Heidecke, Christian Emde, Wolfgang Hoffmann, Ulrike Siewert, Neeltje van den Berg, Wolfram von Bernstorff, Albrecht Stier

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 6/2012

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Gallbladder cancer is the most common malignant tumour of the biliary system with an extraordinarily poor prognosis. In this study, we retrospectively evaluated forty-two patients with histologically proven gallbladder cancer.

Patients and methods

Estimated survival rates were calculated by the Kaplan–Meier method, and differences were assessed using the logrank test. The GKR (combined registry of cancer) and demographic data were used to gain information on community cancer statistics.

Results

In this study, patients with metastases showed poorer survival rates. Furthermore, the survival was significantly better in patients with R0 resections, smaller tumour sizes and without lymph node infiltration. T stage, M stage and R stage were independent prognostic parameters. Sex and age had no significant effect on survival. Also, we found that patients with incidental gallbladder cancer and those with cholecystolithiasis showed significantly better survival rates. Demographic analyses of the study group confirmed a high coverage of our institution for incident cases in our catchment area and no significant regional deviations from the expected incidence of gallbladder cancer.

Conclusion

Despite differences in the incidence in different geographical areas, gallbladder cancer appears to be fairly normally distributed in Western Pomerania, a predominantly rural area of Northeastern Germany. Coverage of incident cases in our catchment area was high. T stage, M stage and R stage were independent prognostic factors in our study. We conclude that, whenever possible, an R0 resection should be the surgical goal in all patients staged resectable before surgery, but heroic resections in patients with highly advanced cancer disease or severe accompanying non-tumour diseases are not warranted.
Literatur
1.
2.
Zurück zum Zitat Puhalla H, Bareck E, Scheithauer W et al (2002) Therapy of gallbladder carcinoma. Experience of a central hospital. Chirurg 73:50–56PubMedCrossRef Puhalla H, Bareck E, Scheithauer W et al (2002) Therapy of gallbladder carcinoma. Experience of a central hospital. Chirurg 73:50–56PubMedCrossRef
3.
Zurück zum Zitat Lemrow SM, Perdue DG, Stewart SL et al (2008) Gallbladder cancer incidence among American Indians and Alaska Natives, US, 1999–2004. Cancer 113:1266–1273PubMedCrossRef Lemrow SM, Perdue DG, Stewart SL et al (2008) Gallbladder cancer incidence among American Indians and Alaska Natives, US, 1999–2004. Cancer 113:1266–1273PubMedCrossRef
4.
Zurück zum Zitat Shrikhande SV, Barreto SG, Singh S et al (2010) Cholelithiasis in gallbladder cancer: coincidence, cofactor, or cause! Eur J Surg Oncol 36:514–519PubMedCrossRef Shrikhande SV, Barreto SG, Singh S et al (2010) Cholelithiasis in gallbladder cancer: coincidence, cofactor, or cause! Eur J Surg Oncol 36:514–519PubMedCrossRef
6.
Zurück zum Zitat Mekeel KL, Hemming AW (2007) Surgical management of gallbladder carcinoma: a review. J Gastrointest Surg 11:1188–1193PubMedCrossRef Mekeel KL, Hemming AW (2007) Surgical management of gallbladder carcinoma: a review. J Gastrointest Surg 11:1188–1193PubMedCrossRef
7.
Zurück zum Zitat Kondo S, Nimura Y, Kamiya J et al (2002) Mode of tumor spread and surgical strategy in gallbladder carcinoma. Langenbecks Arch Surg 387:222–228PubMedCrossRef Kondo S, Nimura Y, Kamiya J et al (2002) Mode of tumor spread and surgical strategy in gallbladder carcinoma. Langenbecks Arch Surg 387:222–228PubMedCrossRef
8.
Zurück zum Zitat Orth K, Beger HG (2000) Gallbladder carcinoma and surgical treatment. Langenbecks Arch Surg 385:501–508PubMedCrossRef Orth K, Beger HG (2000) Gallbladder carcinoma and surgical treatment. Langenbecks Arch Surg 385:501–508PubMedCrossRef
9.
Zurück zum Zitat Goetze TO, Paolucci V (2010) Adequate extent in radical re-resection of incidental gallbladder carcinoma: analysis of the German registry. Surg Endosc. doi:10.1007/s00464-010-0914-4 Goetze TO, Paolucci V (2010) Adequate extent in radical re-resection of incidental gallbladder carcinoma: analysis of the German registry. Surg Endosc. doi:10.​1007/​s00464-010-0914-4
10.
Zurück zum Zitat Sobin LH, Gospodarowicz MK, Wittekind C (2009) TNM Classification of Malignant Tumours, 7th edition, John Wiley and Sons, New York Sobin LH, Gospodarowicz MK, Wittekind C (2009) TNM Classification of Malignant Tumours, 7th edition, John Wiley and Sons, New York
11.
Zurück zum Zitat Jayaraman S, Jarnagin WR (2010) Management of gallbladder cancer. Gastroenterol Clin North Am 39:331–342PubMedCrossRef Jayaraman S, Jarnagin WR (2010) Management of gallbladder cancer. Gastroenterol Clin North Am 39:331–342PubMedCrossRef
12.
Zurück zum Zitat Kiran RP, Pokala N, Dudrick SJ (2007) Incidence pattern and survival for gallbladder cancer over three decades—an analysis of 10301 patients. Ann Surg Oncol 14:827–832PubMedCrossRef Kiran RP, Pokala N, Dudrick SJ (2007) Incidence pattern and survival for gallbladder cancer over three decades—an analysis of 10301 patients. Ann Surg Oncol 14:827–832PubMedCrossRef
13.
Zurück zum Zitat Schauer RJ, Meyer G, Baretton G et al (2001) Prognostic factors and long-term results after surgery for gallbladder carcinoma: a retrospective study of 127 patients. Langenbecks Arch Surg 386:110–117PubMedCrossRef Schauer RJ, Meyer G, Baretton G et al (2001) Prognostic factors and long-term results after surgery for gallbladder carcinoma: a retrospective study of 127 patients. Langenbecks Arch Surg 386:110–117PubMedCrossRef
14.
Zurück zum Zitat Bartlett DL, Fong Y, Fortner JG et al (1996) Long-term results after resection for gallbladder cancer. Implications for staging and management. Ann Surg 224:639–646PubMedCrossRef Bartlett DL, Fong Y, Fortner JG et al (1996) Long-term results after resection for gallbladder cancer. Implications for staging and management. Ann Surg 224:639–646PubMedCrossRef
15.
Zurück zum Zitat Shimada H, Endo I, Fujii Y et al (2000) Appraisal of surgical resection of gallbladder cancer with special reference to lymph node dissection. Langenbecks Arch Surg 385:509–514PubMedCrossRef Shimada H, Endo I, Fujii Y et al (2000) Appraisal of surgical resection of gallbladder cancer with special reference to lymph node dissection. Langenbecks Arch Surg 385:509–514PubMedCrossRef
16.
Zurück zum Zitat Ito H, Matros E, Brooks DC et al (2004) Treatment outcomes associated with surgery for gallbladder cancer: a 20-year experience. J Gastrointest Surg 8:183–190PubMedCrossRef Ito H, Matros E, Brooks DC et al (2004) Treatment outcomes associated with surgery for gallbladder cancer: a 20-year experience. J Gastrointest Surg 8:183–190PubMedCrossRef
17.
Zurück zum Zitat Wakabayashi H, Ishimura K, Hashimoto N et al (2004) Analysis of prognostic factors after surgery for stage III and IV gallbladder cancer. Eur J Surg Oncol 30:842–846PubMed Wakabayashi H, Ishimura K, Hashimoto N et al (2004) Analysis of prognostic factors after surgery for stage III and IV gallbladder cancer. Eur J Surg Oncol 30:842–846PubMed
18.
Zurück zum Zitat Tazuma S, Kajiyama G (2001) Carcinogenesis of malignant lesions of the gall bladder. The impact of chronic inflammation and gallstones. Langenbecks Arch Surg 386:224–229PubMedCrossRef Tazuma S, Kajiyama G (2001) Carcinogenesis of malignant lesions of the gall bladder. The impact of chronic inflammation and gallstones. Langenbecks Arch Surg 386:224–229PubMedCrossRef
19.
Zurück zum Zitat Foster JM, Hoshi H, Gibbs JF et al (2007) Gallbladder cancer: defining the indications for primary radical resection and radical re-resection. Ann Surg Oncol 14:833–840PubMedCrossRef Foster JM, Hoshi H, Gibbs JF et al (2007) Gallbladder cancer: defining the indications for primary radical resection and radical re-resection. Ann Surg Oncol 14:833–840PubMedCrossRef
20.
Zurück zum Zitat Lazcano-Ponce EC, Miquel JF, Munoz N et al (2001) Epidemiology and molecular pathology of gallbladder cancer. CA Cancer J Clin 51:349–364PubMedCrossRef Lazcano-Ponce EC, Miquel JF, Munoz N et al (2001) Epidemiology and molecular pathology of gallbladder cancer. CA Cancer J Clin 51:349–364PubMedCrossRef
21.
Zurück zum Zitat Randi G, Franceschi S, La Vecchia C (2006) Gallbladder cancer worldwide: geographical distribution and risk factors. Int J Cancer 118:1591–1602PubMedCrossRef Randi G, Franceschi S, La Vecchia C (2006) Gallbladder cancer worldwide: geographical distribution and risk factors. Int J Cancer 118:1591–1602PubMedCrossRef
Metadaten
Titel
Outcomes and prognostic factors in gallbladder cancer: a single-centre experience
verfasst von
Katharina Cziupka
Lars Ivo Partecke
Lutz Mirow
Claus-Dieter Heidecke
Christian Emde
Wolfgang Hoffmann
Ulrike Siewert
Neeltje van den Berg
Wolfram von Bernstorff
Albrecht Stier
Publikationsdatum
01.08.2012
Verlag
Springer-Verlag
Erschienen in
Langenbeck's Archives of Surgery / Ausgabe 6/2012
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-012-0950-8

Weitere Artikel der Ausgabe 6/2012

Langenbeck's Archives of Surgery 6/2012 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.