To evaluate the surgical efficacy and to explore the prognostic factors of gallbladder cancer.

Clinical data of 162 patients with gallbladder cancer admitted to the First Medical Center of Chinese PLA General Hospital from January 2013 to January 2015 were retrospectively analyzed. Among them, 77 patients were male and 85 female, aged (61±11) years on average. The informed consents of all patients were obtained and the local ethical committee approval was received. 9 cases were classified as stage T1a, 10 cases of stage T1b, 28 cases of stage T2, 103 cases of stage T3 and 12 cases of stage T4, respectively. Intraoperative and postoperative conditions of all patients were observed. The factors affecting survival and prognosis were analyzed. Survival analysis was performed by Kaplan-Meier method and Log-rank test. The independent prognostic factors were identified by Cox proportional hazards regression model.

Simple cholecystectomy was performed in 9 cases with stage T1a. Among the 153 cases with stage T1b and above, radical resection was conducted in 81 cases, palliative surgery in 45 cases and abdominal exploration in 27 cases. 140 patients were followed up after surgery. The median survival time was 12(9-15) months. The 1-, 3- and 5-year cumulative survival rates were 51.4%, 25.0% and 22.1%, respectively. The 5-year survival rates of patients with stage T2b undergoing wedge resection and patients receiving segment Ⅳb+Ⅴresection were 44.4% and 100.0%, where significant difference was observed between two groups (χ2=9.00, P<0.05). The 5-year survival rate of patients with stage T3 after radical resection and more than 6 lymph nodes dissection was 33.3%, significantly higher than 4.5% in their counterparts with less than 6 lymph nodes dissection (χ2=4.17, P<0.05). Cox proportional hazards regression model analysis showed that TNM staging and R0 resection were the independent influencing factors for the survival of patients with stage T1b and above gallbladder cancer after radical resection (HR=1.08, 3.23; P<0.05).

Segment Ⅳb+Ⅴresection can bring clinical benefits to patients with stage T2b gallbladder cancer. Local dissection of more than 6 lymph nodes can benefit patients with stage T3 gallbladder cancer. TNM staging and R0 resection are the independent prognostic factors of patients with stage T1b and above gallbladder cancer after radical resection.