Abstract
Background
This study sought to evaluate the prognostic heterogeneity of Stage III (Union for
International Cancer Control, seventh edition) gallbladder carcinoma.
Methods
Of 175 patients enrolled with gallbladder carcinoma who underwent radical resection,
22 were classified with Stage IIIA disease (T3N0M0) and 46 with Stage IIIB disease
(T2N1M0 [n = 23] and T3N1M0 [n = 23]). The median number of retrieved lymph nodes
per patient was 18.
Results
This staging system failed to stratify outcomes between Stages IIIA and IIIB; survival
after resection was better for patients with Stage IIIB disease than for patients
with Stage IIIA disease, with 5-year survival of 54.9% and 41.0%, respectively (p = 0.366).
Multivariate analysis for patients with Stage III disease revealed independently better
survival for patients with T2N1M0 than for patients with T3N0M0 (p = 0.016) or T3N1M0
(p = 0.001), with 5-year survival of 77.0%, 41.0%, and 31.0%, respectively. When N1
status was subdivided according to the number of positive nodes, 5-year survival in
patients with T2M0 with 1–2 positive nodes, T2M0 with ≥3 positive nodes, T3M0 with
1–2 positive nodes, and T3M0 with ≥3 positive nodes was 83.3%, 50.0%, 45.8%, and 0%,
respectively (p < 0.001).
Conclusions
The prognosis of T2N1M0 disease was better than that of T3N0/1M0 disease, suggesting
that not all node-positive patients will have uniformly poor outcomes after resection
of gallbladder carcinoma. T2M0 with 1–2 positive nodes leads to a favorable outcome
after resection, whereas T3M0 with ≥3 positive nodes indicates a dismal prognosis.
Keywords
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Article info
Publication history
Published online: January 19, 2017
Accepted:
January 9,
2017
Identification
Copyright
© 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
