P-157 - The prognostic factors for operated gallbladder cancer

Abstract

Introduction: Surgery is the only curative treatment for localized gallbladder cancer. The prognosis is poor because low rate of patients can be found eligible for potential curative surgery. Lymph node metastasis is known to be strongest prognostic factor for survival. The aim of this study was to determine the disease free (DFS) and overall survival (OS) of operated gallbladder cancer in our country. Methods: We retrospectively analyzed 54 localized gallbladder cancer who underwent surgery in 4 different Oncology Center in Istanbul. The prognostic factors for survival were evaluated by by univariate and multivariate analysis. Results: The median age of the patients was 62 (range 38-86) and over 61% of them was female. The median OS and 3-year OS rates were 35 months and 48.5%, respectively. On the other hand, median DFS and 3-year DFS rates were 23 months and 38.4%, respectively. Totally 33 patients (61.1%) were diagnosed incidentally during simple cholecystectomy which was performed for benign causes but only 39.4% of them were underwent complementary surgery. Lymph node metastasis were detected after surgery in 42.5% of the patients and R0 resection could be available for 63% of them. Nearly 52% of the patients were given adjuvant chemotherapy postoperatively, but in 53.7% of patients the recurrence was detected during 23 months of follow-up time. R0 resection, pathological stage, lymphatic (LI), vascular (VI) and perineural invasion (PNI) and the presence of adjuvant chemotherapy were found to be related with both OS and DFS by univariate analysis. Lymph node metastasis was also related with DFS. Regional recurrence and multiple metastasis were more common among patient who didn’t underwent complementary surgery. The multivariate analysis indicated that LI [HR: 0.09 (95% CI: 0.01-80.7), p = 0.02], PNI [HR: 2.93 (95% CI: 1.01-8.51), p = 0.04] and stage [HR: 0.02 (95% CI: 0.02-0.16), p = 0.001] were an independent prognostic factors for DFS. Conclusion: Our results showed that incidental diagnosis or patients surgery was not related with DFS or OS, but pathological factors like LI and PNI predict the DFS for resected gallbladder cancer.