Clinical Analysis of the Primary Gallbladder Cancer

原發性膽囊癌的臨床分析

陳志仁(Chih-Jen Chen) ； 王蒼恩(Tsang-En Wang) ； 張文熊(Wen-Hsiung Chang) ； 林錫泉(Shee-Chan Lin) ； 白明忠(Ming-Jong Bair) ； 李晉賢(Chin-Hsien Lee)

《中華民國癌症醫學會雜誌》 24卷1期 (2008/02) Pp. 60-66

https://doi.org/10.6588/JCOS.2008.24.1.8

摘要

Prognosis of primary gallbladder cancer is very poor. It is not only hard to diagnose in the early stage, but also responds poorly to treatment. We have retrospectively analyzed and discussed the cases of primary gallbladder cancer at our hospital, including the clinical presentation, the pre- and post-operative diagnoses, the methods of surgery and the outcomes. From January 1984 to December 2003, 73 patients were diagnosed with gallbladder cancer, including 7 cases from our Taitung branch hospital. Fifty-six cases received operation. The patients were followed for an average of 18 months postoperatively. Of these, 45 cases were analyzed. Twenty-four patients were female and 21 were male. The average age was 67 years. Five cases underwent laparoscopic cholecystectomy and 33 received open cholecystectomy. The clinical presentation was predominantly right upper quadrant pain and epigastric pain, seen in 86.7% of patients. CA19-9 was the tumor marker most frequently elevated, followed by CEA and α FP. Diagnosis was most frequently based on computed tomography (40%), followed by abdominal ultrasonography (33.3%) and endoscopic retrograde cholangiopancreaticosocpy (11.1%). Disease stage and survival time were inversely correlated. Tumors located within the gallbladder wall (stage Ⅰ~Ⅲ) had a better prognosis when compared with late stage tumors (stage Ⅳ~Ⅴ) (p＜0.002). It is our goal to learn more about the disease course and related prognostic factors through extensive literature review and thereby offer aggressive treatment plans.

關鍵字

膽囊癌 ； 膽囊切除

並列摘要

Prognosis of primary gallbladder cancer is very poor. It is not only hard to diagnose in the early stage, but also responds poorly to treatment. We have retrospectively analyzed and discussed the cases of primary gallbladder cancer at our hospital, including the clinical presentation, the pre- and post-operative diagnoses, the methods of surgery and the outcomes. From January 1984 to December 2003, 73 patients were diagnosed with gallbladder cancer, including 7 cases from our Taitung branch hospital. Fifty-six cases received operation. The patients were followed for an average of 18 months postoperatively. Of these, 45 cases were analyzed. Twenty-four patients were female and 21 were male. The average age was 67 years. Five cases underwent laparoscopic cholecystectomy and 33 received open cholecystectomy. The clinical presentation was predominantly right upper quadrant pain and epigastric pain, seen in 86.7% of patients. CA19-9 was the tumor marker most frequently elevated, followed by CEA and α FP. Diagnosis was most frequently based on computed tomography (40%), followed by abdominal ultrasonography (33.3%) and endoscopic retrograde cholangiopancreaticosocpy (11.1%). Disease stage and survival time were inversely correlated. Tumors located within the gallbladder wall (stage Ⅰ~Ⅲ) had a better prognosis when compared with late stage tumors (stage Ⅳ~Ⅴ) (p＜0.002). It is our goal to learn more about the disease course and related prognostic factors through extensive literature review and thereby offer aggressive treatment plans.

並列關鍵字

Gallbladder cancer ； Cholecystectomy