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[Operation or intervention in advanced gallbladder carcinoma?]

R Schauer1, H G Rau, H Grundner

  • 1Chirurgische Klinik und Poliklinik, Klinikum Grosshadern, LMU München.

Langenbecks Archiv Fur Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft Fur Chirurgie. Kongress
|February 5, 1999
PubMed
Summary

Radical tumor resection in advanced gallbladder cancer significantly improves survival. Palliative surgery offers no survival benefit and may reduce quality of life.

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Chemoradiotherapy with concurrent gemcitabine and cisplatin with or without sequential chemotherapy with gemcitabine/cisplatin vs chemoradiotherapy with concurrent 5-fluorouracil in patients with locally advanced pancreatic cancer--a multi-centre randomised phase II study.

British journal of cancer·2009

Area of Science:

  • Surgical Oncology
  • Gastrointestinal Oncology
  • Cancer Research

Background:

  • Gallbladder cancer, particularly locally advanced or metastatic stages, presents significant treatment challenges.
  • Defining optimal surgical strategies for these patients is crucial for improving outcomes.

Purpose of the Study:

  • To evaluate the impact of different surgical approaches (extended resection, palliative surgery, intervention) on survival in patients with advanced gallbladder cancer.
  • To identify patient subgroups that benefit from specific surgical interventions.

Main Methods:

  • Retrospective analysis of 160 surgically treated patients with locally advanced or metastatic gallbladder cancer.
  • Classification of patients based on UICC tumor stages (III and IV) and T-stages (T3, T4).

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  • Comparison of median survival times based on surgical approach and tumor stage.

    • Main Results:

    • 102 patients (73.8%) had UICC stages III and IV.
    • Resection rates were 31% for T3 and 12.5% for T4 tumors, with median survival of 20.2 and 18.1 months, respectively.
    • Patients undergoing only palliative surgery for T3/T4 stages had significantly shorter median survival (2.5–4.5 months).

    Conclusions:

    • Radical tumor resection is the only surgical approach associated with improved survival in advanced gallbladder cancer.
    • Extended resection should be considered even in elderly patients in good condition.
    • Palliative surgery does not enhance survival and can negatively impact quality of life.