Clinical characteristics of T3 gallbladder cancer: the impact of preoperative diagnosis on the clinical course of the patients

Abstract

Purpose: We investigated clinical characteristics of T3 gallbladder (GB) cancer, and compared the clinicopathological characteristics of the patients according to preoperative diagnosis. We studied the prognostic factors for survival after surgical resection of T3 GB cancer. Methods: Subjects were composed of 51 patients with T3 GB cancers who underwent surgical resection from January 1995 to December 2011. We divided the patients according to the preoperative diagnosis: 17 patients who were diagnosed as benign GB disease at preoperative evaluation, and confirmed GB cancer from pathological result after operation (group 1); and 34 patients who were diagnosed as GB cancer at preoperative work up (group 2). We performed univariate and multivariate analyses of the prognostic factors for survival. Results: Significantly lower proportion of the group 1 patients received liver resection, lymph node dissection, and extrahepatic bile duct resection than group 2 patients. R0 resection was performed in 23.5% of the group 1 and. 67.6% of the group 2 (P=0.007). In the univariate analysis for survival, lymph node dissection and R0 resection were statistically significant prognostic factors. In the multivariate analysis, R0 resection was an independent prognostic factors for survival (hazard ratio, 3.404; P=0.013). Conclusion: Group 1 patients tended to perform less R0 resection than group 2 patients. In the T3 gallbladder cancer, curative resection was the only factor to offer survival benefit. Therefore exact preoperative diagnosis might be important. If GB cancer was diagnosed during or after operation, additional resection to achieve R0 resection should be performed to enhance the survival.