[Mortality due to gallbladder cancer: retrospective analysis in three Chilean hospitals]
Mauricio Gabrielli1, Sebastián Hugo, Angélica Domínguez
1Departamento Cirugía Digestiva, Pontificia Universidad, Católica de Chile, Chile.
Insights
Gallbladder cancer (GBC) survival rates in Chile are influenced by diagnosis stage, not hospital location. Early GBC detection significantly improves patient survival outcomes.
Area of Science:
- Oncology
- Epidemiology
- Public Health
Context:
- Chile exhibits the world's highest gallbladder cancer (GBC) mortality rate, with a particular prevalence in southern regions.
- Understanding regional disparities in GBC outcomes is crucial for targeted public health interventions.
Purpose:
- To compare the survival rates of gallbladder cancer (GBC) patients treated across different healthcare facilities in areas with varying GBC risk levels.
- To investigate the influence of hospital location (southern Chile vs. Metropolitan Santiago) on GBC patient survival.
Summary:
- A review of 598 gallbladder cancer (GBC) cases revealed no significant differences in age or sex distribution among hospitals.
- While initial survival rates varied, adjusting for diagnosis stage eliminated survival differences between hospitals in southern Chile and Santiago.
- Stage at diagnosis emerged as the sole significant predictor of survival, with median survival days decreasing substantially from stage I to stage IV.
Impact:
- The study highlights that the stage of gallbladder cancer (GBC) at diagnosis is the critical factor determining patient survival, irrespective of treatment facility.
- Findings underscore the importance of early GBC detection and diagnosis to improve patient prognosis and reduce mortality in high-risk populations.
Background:
Chile has the highest gallbladder cancer (GBC) death rate world-wide, affecting mainly Southern areas of the country.
Aim:
To compare the survival of GBC patients treated in hospitals located in areas with low and high risk for GBC.
Material And Methods:
Medical records of all patients with GBC admitted to one public hospital located in southern Chile, a public hospital and a private clinic, both located in Metropolitan Santiago, were reviewed. Cases were analyzed by age, sex, stage at diagnosis, ethnicity, socioeconomic status (SES) and rural residence. Survival was calculated using Kaplan Meier method.
Results:
A total of 598 cases (469 women), were analyzed. No differences in age or sex among hospitals were detected. At the moment of diagnosis, 75, 50 and 44% of cases from the hospital in southern Chile, the public hospital in Santiago and the private clinic in Santiago, were in stage IV, respectively. Five years survival was lower in the public hospital in southern Chile than in the public hospital in Santiago (10.7 and 14.4% respectively, p < 0.05) but not statistically different from the figure at the private clinic in Santiago (13.0%). However, when adjusting for stage at the moment of diagnosis, no difference in survival between the three hospitals, was found. The median days of survival were 1,559, 188, 70 and 69 for stages I, II, III and IV respectively.
Conclusions:
GBC mortality is high. The stage at the moment of diagnosis is only significant predictor of survival.
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