[Cancer of the gallbladder. A surgical experience]

Between 1965 and 1987, carcinoma of the gallbladder was found in 65 patients, 59 of whom were operated upon. Seventy-seven per cent of these patients were women. Mean age was 68 years. Cholelithiasis was present in 77 per cent of the patients. Since 1977, the preoperative diagnosis was made by ultrasonography in 43 per cent of the cases. The overall actuarial 1-year, 5-year and 10-year survival rates were 30, 13 and 13 per cent respectively. For patients whose tumour was limited to the gallbladder wall (Tis, T1, T2), the actuarial 5-year survival rate was 73 per cent. For patients with T3 and T4 tumour, the 2-year survival rate was nil. The resection rate with "curative aim" was 25 per cent, but recurrences occurred in 3 patients (2 T2, 1 T3) out of 11 after cholecystectomy and in 4 patients (1 T2, 3 T3) out of 5 after cholecystectomy and wedge resection of the liver at gallbladder fossa level with regional lymph node dissection. No major hepatic resection was performed. The prognosis mainly depended on the tumoral extension in depth. For the early stages, the survival rate could be higher with a more aggressive surgical procedure. For the usually observed tumours which extend beyond the gallbladder wall, the prognosis has not been improved.