Influence of operation on the prognosis of stage IV gallbladder carcinoma

Objective To analyze the prognostic value of different surgical procedures for patients with stage Ⅳ gallbladder carcinoma. Methods A clinicopathologic study was performed on 172 patients with stage Ⅳ gallbladder carcinoma diagnosed in Shanghai from June. 1997 to May, 2001. And the relationship between prognosis and surgical procedure was explored according to the available follow-up data of 164 patients. The Kaplan-Meier method was employed to analyze the survival data. Results Among the total 172 cases, 128 patients(74. 4%) underwent operation. Simple cholecystectomy was performed on 45 patients (35. 1 %),and radical cholecystectomy on 17 patients (13. 3%). Five patients (3. 9%) underwent extensive resection and the remaining 61 (47. 7%) only received explosive laparotomy. The 1-year survival rates were 69. 2% and 40. 7% respectively for stage Ⅳ a and Ⅳ b disease in the radical resection group. They were significantly better than those in unresected or simple cholecystectomy groups. Two patients with stage Ⅳ a and 2 with stage Ⅳ b disease survived more than 5 years. Conclusion Radical cholecystectomy or extensive surgery may contribute to better prognosis in selected patients with stage Ⅳ gallbladder carcinoma.