[Prognostic factor in gallbladder cancer]. / Factores pronósticos en cáncer de vesícula.

ABSTRACT

BACKGROUND: Gallbladder cancer is a rare and aggressive neoplasm. OBJECTIVE: The purpose of this manuscript was to evaluate the prognostic factors associated with overall survival in gallbladder cancer patients. METHODS: We performed a retrospective study of the patients with gallbladder cancer who received attention in a tertiary referral center in Mexico City during a 13 year period (1990-2002). We evaluated demographic, clinical, pathological and treatment variables. The main outcome variable was overall survival. The survival curves were constructed with the Kaplan and Meier method and compared with the log-rank test. Multivariate analyses was performed with the Cox regression method. We considered significant p < 0.05. RESULTS: Fifty-one patients were registered, 35 of them women (69%). Median patient age was 63 years. Fifty-seven percent of patients had previous diagnosis of cholelithiasis. Seventy-one percent of patients underwent surgery. Ninety-eight percent of the tumors were adenocarcinoma and 25% were poorly differentiated. Eighty-six percent were found to have stage IV. Median survival for the entire cohort was six months (95% CI 0.5-7), and actuarial survival at one and three years was 22.7% and 3.9% respectively. On univariate analysis surgery, early stage, chemotherapy, Karnofsky 2 80 and serum albumin > 3.0 g/dL were associated with better prognosis. On multivariate analysis, only surgery (p = 0.0001) and serum albumin > 3 g/dL (p = 0.002) remained significantly associated with better outcome. CONCLUSIONS: Most cases of gallbladder cancer presented with advanced stage. Serum albumin is a prognostic factor for survival in this group of patients.