The relationship between postoperative survival rate and clinical stage of gallb ladder carcinoma

Purpose:To evaluate the relationship between po stoperative survival rate and three stage systems (Nevin,AJCC,JSBS) of gallbladd er carcinoma. Methods:From October 1988 to December 1998 a total of 30 patien ts with gallbladder carcinoma underwent radical resection in the Xinhua Hospital . All patients were classified by 3 different methods of staging.The 1-year,3- year ,5-year postoperative survival rates were evaluated according to the stage . Results:All patients with stage Ⅰ were alive. There were less cases in Nevin’s stageⅡ,Ⅲ. The 3-year,5-year survival rates in patients wit h Nevin’s stage Ⅱ,Ⅲ were better than the other two classifications. The 5-ye ar survival rates in patients with Nevin’s stage Ⅲ were better than those with Nevin’s stage Ⅳ. The 3-year,5-year survival rates in patients with Nevin’s stage Ⅳ/Ⅴ were significantly better than the other two classifications (P 0.05).There were no long-time survivors in JSBS and AJCC stage Ⅳ cases,their the postoperative 5-year survival rates were 0.The 3-year survival rate of sta ge Ⅳ defined by the JSBS was significantly worse than the same stage in AJCC cl assification(P0.01). The difference in the 3-year survival rates between s tage Ⅲ and stage Ⅳ was significant(P0.05) in the JSBS system but not in t he AJCC systems. Conclusions:The postoperative survival rate was significantly a ffected by the clinical stage of gallbladder carcinoma. The JSBS classification defined stages with tumor invasion and lymph node metastasis in detail. It is a better staging system to compare effect of surgery and estimate prognosis. In st ages Ⅰto Ⅲ as defined by JSBS, radical resection should be performed. In patie nts with stage Ⅳ as defined by the JSBS (a tumor that extends more than 2 cm in to the liver or into two or more adjacent organs or who have peripancreatic, cel iac, superior mesenteric and paraaorta lymph node metastasis), the benefit of ra dical resection seems limited.