Preoperative Systemic Inflammation and Complications Affect Long-term Gallbladder Carcinoma Outcomes Following
Tomoyuki Abe1, Hironobu Amano2, Keiji Hanada3
1Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima, Japan.
Background/Aim:
Gallbladder carcinoma (GBCA) has extremely poor outcomes. We aimed to investigate clinicopathological prognostic variables, including the modified Glasgow prognostic score (mGPS), for patients with resected GBCA.
Patients And Methods:
This retrospective study included 54 patients with GBCA resected between 1996 and 2014. Univariate and multivariate analyses were performed to identify prognostic factors associated with overall and recurrence-free survival.
Results:
Curative resection (R0) was achieved in 43 patients (79.6%). The median patient age was 74 years (range=25-99 years), and the majority (n=33, 61.1%) were women. Incidental GBCA was detected in 18 patients (33.3%). The overall and recurrence-free survival rates were 63.3% and 55.8% at 3 years and 58.4% and 51.3% at 5 years, respectively. In multivariate analysis, postoperative intra-abdominal complications (p=0.015), non-curative resection (p=0.008), worse histological type (p=0.003), and elevated mGPS (p=0.002) were independent predictors of worse overall survival. Surgical complications (p=0.015), non-curative resection (p=0.005), worse histological type (p=0.002), and elevated mGPS (p=0.022) were also independent predictors of worse recurrence-free survival.
Conclusion:
Curative resection was important for long-term survival for GBCA. A high preoperative mGPS and occurrence of surgical complications were independent prognostic indicators of poor survival in GBCA.
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