Extended Surgery for Advanced Carcinoma of the Gallbladder -A Comparative Study between JSBS and AJCC Classification, Based on Prognosis-

Atsutake Okamoto, Kohji Tsuruta, Tokio Onodera*

Department of Surgery, Tokyo Metropolitan Komagome Hospital
*Tokyo Metropolitan Fuchyu Hospital

Thirty-seven patients with advanced carcinoma of the gallbladder (14 in stage III and 23 in stage IV according to the General Rules by JSBS) who received macroscopically curative tumor removal were analyzed retrospectively. Five types of hepatic resection combined with resection of adjacent organs were performed in 25 patients. Eight patients survived more than 3 years after the surgery. Three of the 8 patients had histologic tumor invasion to the adjacent organs (transverse colon, abdominal muscle and major omentum) (stage IV). In the other 5 patients the tumors had spread into the serosa of the gallbladder (stage III). Seven of the 8 patients had neither regional lymph node involvement nor tumor invasion to the hepatoduodenal ligament. There was no significant difference in survival rate between stage III and IV of JSBS. On the other hand, according to the TNM classification by AJCC, 15 of the 37 patients were in stage II, 18 were in stage III, and 4 were in stage IV. There was a significant difference in survival rate between stage II and III (p<0.01). Thus, in this series, the classification by AJCC seems to be reasonable because it sets a high value on regional lymph node involvement as a prognostic factor of carcinoma of the gallbladder.

Key words
carcinoma of the gallbladder, prognostic factor, AJCC

Reprint requests
Atsutaka Okamoto Department of Surgery, Tokyo Metropolitan Komagome Hospital
3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
November 11, 1992

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