Preoperative Systemic Inflammation and Complications Affect Long-term Gallbladder Carcinoma Outcomes Following Surgery with Curative Intent.

Abstract

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. 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. 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. 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.