The time of diagnosis impacts surgical management but not the outcome of patients with gallbladder Carcinoma
<p>Abstract</p> <p>Background</p> <p>Only 50% of gallbladder cancers (GBC) are recognized before operation and the remaining tumors are diagnosed during surgery or afterwards by the pathologist. These situations may demand substantial modifications of the proceeding dur...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2009-08-01
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| Series: | European Journal of Medical Research |
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| Online Access: | http://www.eurjmedres.com/content/14/8/345 |
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| author | Löhe F Meimarakis G Schauer C Angele M Jauch KW Schauer RJ |
| author_facet | Löhe F Meimarakis G Schauer C Angele M Jauch KW Schauer RJ |
| author_sort | Löhe F |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Only 50% of gallbladder cancers (GBC) are recognized before operation and the remaining tumors are diagnosed during surgery or afterwards by the pathologist. These situations may demand substantial modifications of the proceeding during surgery as well as the need for reoperation in some cases. Therefore, the time of diagnosis may strongly influence the surgical management of GBC and the prognosis of the patients.</p> <p>Methods</p> <p>Records and follow-up of 152 patients with gallbladder carcinoma who underwent surgery between 1980 and 2004 were examined according to the time of diagnosis, TNM staging system, surgical procedures, morbidity and predictors of survival. There were 76 patients with preoperative diagnosis of GBC (50%; group1), 44 patients with intraoperative diagnosis (29%; group 2) and 32 patients (21%; group 3) with postoperatively incidental finding of GBC. In all cases radical resection of the GBC was intended, except in 5 patients from group 1. Surgical procedures comprised from simple cholecystectomy to multivisceral resections.</p> <p>Results</p> <p>Overall 5-year survival rate was 7% with a significantly better median survival in group 3 (53.2 month), when compared to only 6.1 month (group 2) and 5.4 month (group 1), respectively. Findings at operation forced significant modifications of the surgical strategy in 85%. Complete resection of GBC was achieved in 38% of the patients. Stage- dependent survival was comparable between the groups following R0 resection. Tumor stage, in particular the nodal status and radicality of the procedure, but not the time of diagnosis were the most powerful predictors of outcome.</p> <p>Conclusions</p> <p>Complete tumor resection may provide long-term survival even in locally advanced GBC. Although the time of diagnosis of GBC causes significant changes of the intended procedures during and after surgery, it has no influence on the prognosis provided that radical (R0) resection was accomplished.</p> |
| first_indexed | 2024-12-10T14:51:54Z |
| format | Article |
| id | doaj.art-eac89531a21846fdb049f61fdf029a5a |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-12-10T14:51:54Z |
| publishDate | 2009-08-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-eac89531a21846fdb049f61fdf029a5a2022-12-22T01:44:26ZengBMCEuropean Journal of Medical Research2047-783X2009-08-0114834510.1186/2047-783X-14-8-345The time of diagnosis impacts surgical management but not the outcome of patients with gallbladder CarcinomaLöhe FMeimarakis GSchauer CAngele MJauch KWSchauer RJ<p>Abstract</p> <p>Background</p> <p>Only 50% of gallbladder cancers (GBC) are recognized before operation and the remaining tumors are diagnosed during surgery or afterwards by the pathologist. These situations may demand substantial modifications of the proceeding during surgery as well as the need for reoperation in some cases. Therefore, the time of diagnosis may strongly influence the surgical management of GBC and the prognosis of the patients.</p> <p>Methods</p> <p>Records and follow-up of 152 patients with gallbladder carcinoma who underwent surgery between 1980 and 2004 were examined according to the time of diagnosis, TNM staging system, surgical procedures, morbidity and predictors of survival. There were 76 patients with preoperative diagnosis of GBC (50%; group1), 44 patients with intraoperative diagnosis (29%; group 2) and 32 patients (21%; group 3) with postoperatively incidental finding of GBC. In all cases radical resection of the GBC was intended, except in 5 patients from group 1. Surgical procedures comprised from simple cholecystectomy to multivisceral resections.</p> <p>Results</p> <p>Overall 5-year survival rate was 7% with a significantly better median survival in group 3 (53.2 month), when compared to only 6.1 month (group 2) and 5.4 month (group 1), respectively. Findings at operation forced significant modifications of the surgical strategy in 85%. Complete resection of GBC was achieved in 38% of the patients. Stage- dependent survival was comparable between the groups following R0 resection. Tumor stage, in particular the nodal status and radicality of the procedure, but not the time of diagnosis were the most powerful predictors of outcome.</p> <p>Conclusions</p> <p>Complete tumor resection may provide long-term survival even in locally advanced GBC. Although the time of diagnosis of GBC causes significant changes of the intended procedures during and after surgery, it has no influence on the prognosis provided that radical (R0) resection was accomplished.</p>http://www.eurjmedres.com/content/14/8/345Gallbladder cancerSurgeryFollow upPrognosis |
| spellingShingle | Löhe F Meimarakis G Schauer C Angele M Jauch KW Schauer RJ The time of diagnosis impacts surgical management but not the outcome of patients with gallbladder Carcinoma European Journal of Medical Research Gallbladder cancer Surgery Follow up Prognosis |
| title | The time of diagnosis impacts surgical management but not the outcome of patients with gallbladder Carcinoma |
| title_full | The time of diagnosis impacts surgical management but not the outcome of patients with gallbladder Carcinoma |
| title_fullStr | The time of diagnosis impacts surgical management but not the outcome of patients with gallbladder Carcinoma |
| title_full_unstemmed | The time of diagnosis impacts surgical management but not the outcome of patients with gallbladder Carcinoma |
| title_short | The time of diagnosis impacts surgical management but not the outcome of patients with gallbladder Carcinoma |
| title_sort | time of diagnosis impacts surgical management but not the outcome of patients with gallbladder carcinoma |
| topic | Gallbladder cancer Surgery Follow up Prognosis |
| url | http://www.eurjmedres.com/content/14/8/345 |
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