Survival Analysis of Surgical Management of Gallbladder Cancer: Single Center 12-year Experience

Abstract

Purpose: The aim of our study was to assess any difference in disease free and overall survival between incidental gallbladder cancer (IGBC) versus non-incidental gallbladder cancer (NIGBC). Method: 261 patients referred with GB cancer to a tertiary hepatobiliary center in the UK between 2008 and 2020 were included in the study. Survival analysis using Kaplan-Meier method and log rank tests was done. In patients who had oncological resection, Cox regression analysis was performed to identify independent prognostic factors. The study was approved by the departmental ethics committee. Results: IGBC was diagnosed in 91/261 (35%) patients, while 170/261 (65%) patients had NIGBC. 58 patients with IGBC and 32 patients with NIGBC had oncological resection (total 90 patients). Median overall survival (OS) after surgery for patients with IGBC and NIGBC was 96 and 21 months respectively (P=0.004). Patients with IGBC had also better disease free survival (DFS) than patients with NIGBC, 21.5 vs 8.5 months respectively (P= 0.007). Age, ASA score, T stage, N stage, resection margin (R) status and non-incidental diagnosis were associated with poor survival on univariate analysis. After multivariate analysis, N stage, R status and non-incidental diagnosis were the only independent predictors of survival. Conclusion: NIGBC patients have worse OS and DFS than patients with IGBC. Lymph node involvement, positive resection margins and non-incidental diagnosis were independent predictors of OS.FP07.06_Table 1Results of Cox regression analysis in patients who underwent surgical resection.VariableUnivariate analysisMultivariate analysisP valueHR (95% CI)P valueHR (95% CI)Age0.0111.04 (1.01-1.07)0.4531.02 (0.967-1.08)Gender0.9601.01 (0.706-1.44)--BMI0.6010.983 (0.92-1.05)--ASA score0.0241.96 (1.09-3.52)0.1212.26 (0.81-6.31)T stage<0.0012.73 (1.72-4.34)0.9131.04 (0.562-1.90)N stage<0.0015.65 (2.84-11.25)<0.0013.07 (1.72-5.46)R status<0.0017.35 (3.38-15.95)<0.0015.26 (2.10-13.13)Non-incidental diagnosis0.0042.41 (1.32-4.38)0.0262.25 (1.10-4.58)Adjuvant chemotherapy0.8701.07 (0.47-2.44)- Open table in a new tab