[Controversy on early carcinoma of the gallbladder based on the results of surgical treatment].

Seventy-two cases of carcinoma of the gallbladder removed surgically were retrospectively studied to evaluate the relationship between stage and prognosis, and to define early carcinoma of the gallbladder. These cases were staged according to general rules for surgical studies on cancer of biliary tract (Japanese Biliary Surgical Society). Stage I patients were 23, composed of 13 of mucosal carcinoma, 7 with involvement of the muscularis and 3 with microinvasion into the subserosa. Stage II and III were 14, and Stage IV 35. All patients with mucosal carcinoma were alive with the exception of the one case who died of other cause. Two cases of the remaining 10 Stage I died of recurrence of carcinoma 1.5 years and 2 years after surgery. Five-year survival rates were 100 percent in cases with mucosal carcinoma, 75 percent in cases with muscular involvement or subserosal microinvasion, 31.6 percent in Stage II and III cases. Stage IV was fatal and most of them died within 6 months after surgery. From our data, it may be rational that the early carcinoma of the gallbladder is defined as the carcinoma of which invasion is limited to the mucosa.