Surgical outcomes and prognostic factors influencing long-term survival in patients with gallbladder cancer

BACKGROUNDS/AIMS The aim of this study is to analyze surgical outcomes and prognostic factors affecting survival after surgical resection in patients with gallbladder cancer. METHODS We retrospectively reviewed 86 patients treated surgically for gallbladder cancer from January 2000 to December 2009 at Chonbuk National University Hospital. Clinicopathologic factors, surgical treatment and outcome data were analyzed. RESULTS Among the 86 patients (44 male, 42 female) with gallbladder cancer, the mean age was 62.9 years (range: 32-80) and the median survival was 42.4±3.5 month. The overall cumulative survival rates of 86 patients were for 1 year, 83.7%; 3 year, 67.4%; 5 year survival, 61.7%. Univariate analysis revealed that preoperative serum alanine aminotransferase, alkaline phosphatase, total bilirubin, carcinoembryonic antigen (CEA), T staging, N staging were statistically significantly associated with survival. CEA (p=0.004) and T staging (p=0.005) were associated with survival in multivariate analysis. Two-year survival rates were analyzed according to the methods of surgical resection, with simple cholecystectomy showing 100%, whereas extended cholecystectomy showed about 83% in T1b. We could not find out any adverse effect of the simple cholecystectomy for survival. CONCLUSIONS CEA and T stage are independent significant prognostic factor associated with patient survival in our study. Simple cholecystectomy can be regarded as curative resection in stage T1b. Longer observation periods and more cases will be needed to confirm these conclusions.