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Trends in Presentation and Survival for Gallbladder Cancer During a Period of More Than 4 Decades—Invited Critique
Laurence McCahill, MD
Arch Surg. 2009;144(5):447.
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In 1978, Piehler and Crichlow reviewed the dismal outcomes of patients with gallbladder cancer, reporting a 5-year survival rate of just 4.1%, including those with incidentally discovered gallbladder cancer.1 More than 30 years later, Konstantinidis and colleagues at Massachusetts General Hospital offer some new insights for the few patients who present with relatively early-stage disease. The results of this study add to a growing body of evidence that, for incidentally discovered gallbladder cancer, surgical reexploration with a planned major liver resection (segments V and IVA) and regional lymphadenectomy are indicated because most (50%-75%) patients with T1b, T2, and T3 gallbladder cancer will have additional disease identified at reexploration.
This study suggests that collective wisdom has been passed from one surgical generation to the next. Attempts at surgical "palliation" were less frequent in each successive time period. This likely reflects the incongruities of major surgery and successful palliation . . . [Full Text of this Article]
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Trends in Presentation and Survival for Gallbladder Cancer During a Period of More Than 4 Decades: A Single-Institution Experience
Ioannis T. Konstantinidis, Vikram Deshpande, Muriel Genevay, David Berger, Carlos Fernandez-del Castillo, Kenneth K. Tanabe, Hui Zheng, Gregory Y. Lauwers, and Cristina R. Ferrone
Arch Surg. 2009;144(5):441-447.
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