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Langenbecks Arch Surg ; 397(6): 899-907, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22454256

RESUMO

INTRODUCTION: Gallbladder cancer is the most common malignant tumour of the biliary system with an extraordinarily poor prognosis. In this study, we retrospectively evaluated forty-two patients with histologically proven gallbladder cancer. PATIENTS AND METHODS: Estimated survival rates were calculated by the Kaplan-Meier method, and differences were assessed using the logrank test. The GKR (combined registry of cancer) and demographic data were used to gain information on community cancer statistics. RESULTS: In this study, patients with metastases showed poorer survival rates. Furthermore, the survival was significantly better in patients with R0 resections, smaller tumour sizes and without lymph node infiltration. T stage, M stage and R stage were independent prognostic parameters. Sex and age had no significant effect on survival. Also, we found that patients with incidental gallbladder cancer and those with cholecystolithiasis showed significantly better survival rates. Demographic analyses of the study group confirmed a high coverage of our institution for incident cases in our catchment area and no significant regional deviations from the expected incidence of gallbladder cancer. CONCLUSION: Despite differences in the incidence in different geographical areas, gallbladder cancer appears to be fairly normally distributed in Western Pomerania, a predominantly rural area of Northeastern Germany. Coverage of incident cases in our catchment area was high. T stage, M stage and R stage were independent prognostic factors in our study. We conclude that, whenever possible, an R0 resection should be the surgical goal in all patients staged resectable before surgery, but heroic resections in patients with highly advanced cancer disease or severe accompanying non-tumour diseases are not warranted.


Assuntos
Carcinoma/epidemiologia , Carcinoma/patologia , Colecistectomia/métodos , Neoplasias da Vesícula Biliar/epidemiologia , Neoplasias da Vesícula Biliar/patologia , Linfonodos/patologia , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha , Carcinoma/cirurgia , Estudos de Coortes , Intervalo Livre de Doença , Feminino , Neoplasias da Vesícula Biliar/cirurgia , Alemanha/epidemiologia , Humanos , Imuno-Histoquímica , Incidência , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Medição de Risco , Estatísticas não Paramétricas , Análise de Sobrevida , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
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