[Prognostic factors for the survival time in gallbladder carcinoma]

Survival of 74 patients with proven gallbladder carcinoma was studied retrospectively. Initial treatment consisted of cholecystectomy, cholecystectomy and common bile duct exploration, bypass procedure (hepatojejunostomy) or laparotomy and biopsy or percutaneous biliary drainage. Staging (according to the American Joint Committee on Cancer) was the most important determinant for survival (chi 2 = 29.34; df 3; p less than 0.001). Most individual complaints such as pain (chi 2 = 1.66;), nausea/vomiting (chi 2 = 0.35), and palpable mass (chi 2 = 2.62) were not related significantly with survival. However cachexia (chi 2 = 17.12; df I; p less than 0.001) was correlated with decreased survival. Establishing the diagnosis preoperatively was associated with significantly shorter survival (chi 2 = 22.67; df I; p less than 0.001) than establishment at the moment of hospitalisation. In a hospital where a radical surgical treatment is not performed, less invasive non surgical therapy (insertion of an endoprosthesis) could probably be considered for this group of patients. Selected patients should be referred to a centre for a radical surgical approach.