Fifty-six cases of gallbladder carcinoma treated in our center during the past 14 years (1972-' 86) were investigated clinicopathologically according to General Rules for Surgical and Pathological Studies on Cancer of Biliary Tract, published by the Japanese Society of Biliary Surgery, and the results of surgical treatment for 42 cases were examined, and the following results were obtained.
1) The primary surgical cases were 42 and the resected cases were 18 (42.9%) of the 42. The curative resection cases were 7 (38.9%) of the 18.
2) According to the macroscopical Stages, patients of Stages I, II, III and IV were 2, 3, 2 and 11, respectively. Thirteen (72.2%) of 18 cases were markedly advanced Stages III-IV.
3) With respect to macroscopical appearance, the infiltrative type was the most frequent, in 31 (63.3%) of 49.
4) Most patients in Stage I had tumors of the papillary type with cancer-infiltration to muscle layer. These showed better prognoses, but in Stages II, III and IV, most tumors were infiltrative or nodular types with positive serosal, vascular or perineural invasion. These had poorer prognoses.
5) The 2-year survival rate of 7 cases with curative resection was 51.4%. In 11 cases with non-curative resection, no one survived more than 2 years after the operation.
These results show that extended cholecystectomy with wedge-resection of the liver bed and radical lymphnode-dissection (R2) are indicated in Stage I, and more radical procedures or combined multidisciplinary therapy should be applied in the advanced Stages of this disease.
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