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Excerpt
Dear Editor:
While reviewing the bibliography relating to gallbladder carcinoma, we faced the article by Cubertafond et al.1
The high number of patients observed, collected mainly from a geographic area bordering our country and also from Italy, could make this report very useful for comparison with our own experience. However, in our opinion, several inaccuracies in the article1 make inappropriate the conclusions drawn (by Cubertafond et al.).
First, tumor stage is allegedly based on TNM classification,2 but in fact, the only parameter considered is the degree of primary tumor invasion (T).
Nodal involvement (N) is mentioned generically as present in 81% of the patients, without specification of which nodes are involved (N1 or N2), and without any relationship with stage according to the T parameter (Table 1).
Moreover, confusion is made between the expressions “histologic type” and “cancer stage” of the tumor, indifferently used in the text1(p278) and in tables (Tables 5 and 7) as if they were the same thing (in fact, cancer stage is correct).
The report on surgical interventions performed appears to be comparably inaccurate. In particular, it is not clear whether resection of regional lymph nodes and wedge resection of the liver bed3 was associated invariably to cholecystectomy.
Finally, the conclusive statement that “no progress has been made during the last 10 years in the treatment of gallbladder malignancies” appears inappropriate because no comparison has been made among patients treated in different periods of time.
We look forward to receiving clarifications about these obvious errors.
