Surgical Outcome of Gallbladder Cancer According to TNM Stage

Abstract

Introduction: Surgical outcomes for advanced gallbladder cancer remain unsatisfactory. The aims of this study were to determine the surgical outcome and effectiveness of adjuvant chemotherapy according to TNM stage in patients with gallbladder cancer. Methods: Retrospective analysis was performed in 200 patients undergoing surgery for gallbladder cancer. Surgical outcomes were evaluated and compared between patients with and without adjuvant chemotherapy according to TNM stage. Results: For patients with stage I (n = 27), IIA (n = 18), IIB (n = 28), IIIA (n = 25), IIIB (n = 43), IVA (n = 7), and IVB (n = 52) disease, the 5-year overall survival (OS) following surgery was 90.8%, 94.4%, 73.6%, 33.7%, 57.7%, 14.3%, and 11.8%, respectively (p < 0.001). R0 resection was achieved in all patients with stage I or II disease, in 89.7% of those with stage III disease, and 69.5% of those with stage IV disease. For patients with stage III disease, adjuvant chemotherapy was associated with improved OS (5-year OS, 60.9% vs, 41.1%; p = 0.028) and was an independent prognostic factor (p = 0.039). For patients with stage IV disease, adjuvant chemotherapy seemed to influence OS (5-year OS, 25.1% vs, 5.3%; p = 0.041), whereas R0 resection (p = 0.040) was the only independent prognostic factor in this group of patients. Conclusion: TNM stage clearly predicts survival following resection for gallbladder cancer. R0 resection with adjuvant chemotherapy is recommended for patients with stage III or IV gallbladder cancer to achieve long-term survival.