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©The Author(s) 2015.
World J Gastroenterol. Apr 21, 2015; 21(15): 4620-4626
Published online Apr 21, 2015. doi: 10.3748/wjg.v21.i15.4620
Published online Apr 21, 2015. doi: 10.3748/wjg.v21.i15.4620
Table 1 AJCC staging classification system of gallbladder carcinoma, 7th edition
Primary tumor (T) | |||
TX Primary tumor cannot be assessed | |||
T0 No evidence of primary tumor | |||
Tis Carcinoma in situ | |||
T1 Tumor invades lamina propria or muscle layer | |||
T1a Tumor invades lamina propria | |||
T1b Tumor invades muscle layer | |||
T2 Tumor invades muscle layer, no extension beyond the serosa or into the liver | |||
T3 Tumor perforates the serosa and/or directly invades the liver and/ or one other adjacent organ or structure | |||
T4 Tumor invades main portal vein or hepatic artery or invade two or more extrahepatic organs or structures | |||
Regional lymph nodes (N) | |||
NX Regional lymph nodes cannot be assessed | |||
N0 No regional lymph node metastases | |||
N1 Metastases to nodes along the cystic duct, common bile duct, hepatic artery, and/or portal vein | |||
N2 Metastases to periarotic, pericaval, and/or celiac artery lymph nodes | |||
Distant metastasis (M) | |||
M0 No distant metastasis | |||
M1 Distant metastasis | |||
Stage 0 | Tis | N0 | M0 |
Stage I | T1 | N0 | M0 |
Stage II | T2 | N0 | M0 |
Stage IIIA | T3 | N0 | M0 |
Stage IIIB | T1-3 | N1 | M0 |
Stage IVA | T4 | N0-1 | M0 |
Stage IVB | Any T | N2 | M0 |
Any T | Any N | M1 |
Table 2 Patient demographics and tumor differentiation characteristics n (%)
Item | Number | Simple cholecystectomy | Radical cholecystectomy | Palliative resection | No surgery |
Age | |||||
mean ± SD | 63.75 ± 11.86 | 66.61 ± 11.07 | 62.75 ± 11.38 | 63.53 ± 13.19 | 63.68 ± 12.01 |
Range | 29-89 | 50-89 | 36-85 | 29-81 | 39-83 |
Sex | |||||
Male | 61 (40.13) | 10 (16.39) | 22 (36.07) | 13 (21.31) | 16 (26.23) |
Female | 91 (59.87) | 18 (19.78) | 33 (36.26) | 18 (19.78) | 22 (24.18) |
Differentiation | |||||
High | 26 (17.11) | 10 (38.46) | 6 (23.08) | 8 (30.77) | 2 (7.69) |
Median | 50 (32.89) | 9 (18.00) | 26 (52.00) | 7 (14.00) | 8 (16.00) |
Low | 42 (27.63) | 3 (7.14) | 20 (47.62) | 11 (26.19) | 8 (19.05) |
No report | 34 (22.37) | 6 (17.65) | 4 (11.76) | 4 (11.76) | 20 (58.82) |
Total | 152 | 28 (18.42) | 57 (37.50) | 28 (18.42) | 39 (25.66) |
Table 3 Patient numbers of various treatments in each tumor-node-metastasis staging group n (%)
TNM stage | Case | Simple cholecystectomy | Radical cholecystectomy | Palliative resection | Inoperable | P value1 |
0 + I | 18 (11.84) | 12 (66.67) | 6 (33.33) | 0 | 0 | 0.826 |
II | 25 (16.45) | 16 (64.00) | 9 (26.00) | 0 | 0 | 0.114 |
IIIA | 21 (13.82) | 0 | 12 (57.14) | 9 (42.86) | 0 | 0.034 |
IIIB | 21 (13.82) | 0 | 11 (52.38) | 10 (47.62) | 0 | 0.701 |
IVA | 24 (15.79) | 0 | 19 (79.17) | 2 (8.33) | 3 (12.50) | 0.6862 |
IVB | 43 (28.29) | 0 | 0 | 7 (16.28) | 36 (83.72) | 0.001 |
Total | 152 | 28 (18.54) | 57 (37.50) | 28 (18.42) | 39 (25.66) |
Table 4 Postoperative complications presented in different stage groups
TNM stage | Surgical procedures | Age(mean ± SD) | P value | Complication | |
0-I | Simple cholecystectomy | 61.58 ± 10.587 | 0.662 | 1 | Infection under the skin incision with gallbladder bed bleeding |
Radical cholecystectomy | 64.17 ± 13.527 | 0 | |||
II | Simple cholecystectomy | 71.56 ± 9.893 | 0.371 | 0 | |
Radical cholecystectomy | 68.22 ± 6.220 | 1 | Fat liquefaction of incision | ||
IIIA | Radical cholecystectomy | 61.67 ± 12.397 | 0.367 | 0 | |
Palliative resection | 67.00 ± 13.991 | 1 | Biliary fistula | ||
IIIB | Radical cholecystectomy | 65.82 ± 7.973 | 0.510 | 0 | |
Palliative resection | 62.20 ± 14.676 | 2 | Biliary fistula, pulmonary embolism | ||
IVA | Radical cholecystectomy | 67.47 ± 9.553 | 0.066 | 3 | MODS resulting from biliary tract infection (dead), deep vein thrombosis, deterioration of liver function |
Palliative resection and No surgery | 57.80 ± 11.520 | 1 | Lung infection | ||
IVB | Palliative resection | 65.57 ± 14.293 | 0.817 | 3 | Abdominal infection, acute pulmonary edema, subphrenic effusion |
No surgery | 64.39 ± 11.905 | 2 | MODS (dead) |
- Citation: He XD, Li JJ, Liu W, Qu Q, Hong T, Xu XQ, Li BL, Wang Y, Zhao HT. Surgical procedure determination based on tumor-node-metastasis staging of gallbladder cancer. World J Gastroenterol 2015; 21(15): 4620-4626
- URL: https://www.wjgnet.com/1007-9327/full/v21/i15/4620.htm
- DOI: https://dx.doi.org/10.3748/wjg.v21.i15.4620