[Operation or intervention in advanced gallbladder carcinoma?]

In a retrospective study of patients with locally advanced or metastatic gallbladder cancer, we tried to define patient groups, that profit either from extended resection, palliative surgery or intervention. 102 out of 160 operative treated patients (73.8%) had UICC-tumor stages III and IV. Depending on the T-stage, resection rates were 31% for T3-stage and 12.5% for T4-stage tumors. Corresponding median survival times were 20.2 and 18.1 month, respectively. Patients with T3/T4-tumor stages, where only palliative surgery was possible, had median survival times of 2.5 to 4.5 month. So, only radical tumor resection can result in better survival times and should be performed even in elderly patients in good condition. Palliative surgery does not improve survival and, moreover, often not life quality.