medigraphic.com
SPANISH

Revista de Investigación Clínica

Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2005, Number 5

Next >>

Rev Invest Clin 2005; 57 (5)

Prognostic factors in gallbladder cancer

Medina-Franco H, Ramos-Gallardo G, Orozco-Zepeda H, Mercado-Díaz MA
Full text How to cite this article

Language: Spanish
References: 10
Page: 662-665
PDF size: 60.67 Kb.


Key words:

Gallbladder cancer, Prognostic factors, Hypoalbuminemia, Surgery.

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 ≥ 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.


REFERENCES

  1. Ahlgren JD. Medical Oncology. 2a. Ed. Capítulo 39: 714-33.

  2. Shukla VK, Adukia TK, Sing SP, Mishara CP. Micronutrients, antioxidants, and carcinoma of the gallbladder. J Surg Oncol 2003; 84: 31-5.

  3. Ito H, Matros E, Brooks D, Osteen RT, Zinner M, Whang E. Treatment outcomes associated with surgery for gallbladder cancer: a 20 years experience. J Gastroint Surg 2004; 8: 183-90.

  4. Hawkins W, De Matteo RP, Jarnagin WR, Ben-Porat L, Fong Y. Jaundice predicts advanced disease and early mortality in patients with gallbladder cancer. Ann Surg Oncol 2004; 11: 310-15.

  5. Ouchi K, Sugawara T, Ono H, Fujiya T, Kamiyama Y. Diagnostic capability and resectional surgery for early gallbladder cancer. Hepatogastroenterology 1999; 46: 1557-60.

  6. Ouchi K, Mikuni J, Kakugawa T. Laparoscopic cholecystectomy for gallbladder carcinoma: results of a Japanese survey of 498 patients. J Hepatobiliary Surg 2002; 9: 256-60.

  7. Muratore A, Amisano M, Vigano L, Massucco P, Capussotti L. Gallbladder cancer invading the perimuscular connective tissue: results of reresection after prior non-curative operation. Surg Oncol 2003; 83: 212-15.

  8. Malik IA, Aziz Z, Zaidi SH, Sethuraman G. Gemcitabine and cisplatin is a high effective combination chemotherapy in patients with advanced cancer of the gallbladder. Am J Clin Oncol 2003; 26: 174-9.

  9. Malik IA, Aziz Z. Prospective evaluation of efficacy and toxicity of 5-fu and folinic acid (Mayo Clinic regimen) in patients with advanced cancer of the gallbladder. Am J Clin Oncol 2003; 26: 124-6.

  10. Ouchi K, Susuki M, Tominaga T. Survival after surgery for cancer of the gallbladder. Br J Surg 1994; 81: 1655-67.




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Rev Invest Clin. 2005;57