Radical operations for carcinoma of the gallbladder: present status in North America

Experience in the United States of America with the use of radical operations for carcinoma of the gallbladder was reviewed. Four studies using the Nevin clinicopathologic classification were combined for analysis. The 5-year survival rate for patients with stage I disease was 59%; stage II disease, 40%; stage III disease, 9%; stage IV disease, 7%; and stage V disease, 1%. Only one study analyzed the results of surgical procedures according to Nevin staging. No conclusions can be drawn from retrospective studies on the value of operations more radical than simple cholecystectomy. Responses to a questionnaire sent to prominent North American surgeons emphasized the controversial management of patients with this disease.