WITHDRAWN: Poorer clinicopathologic features and better long-term survival in young than old patients with gallbladder cancer treated with surgical resection

Abstract

// Guo-Qing Jiang 1, * , Bao-Huan Zhou 1, 3, * , Dou-Sheng Bai 1, * , Ping Chen 1 , Jian-Jun Qian 1 , Sheng-Jie Jin 1 and Hao-Jun Yang 2 1 Department of Hepatobiliary and Pancreatic Surgery, Clinical Medical College of Yangzhou University, Yangzhou, China 2 Department of General Surgery, Changzhou No.2 People's Hospital, Affiliated Hospital of Nanjing Medical University, Changzhou, China 3 Department of Hepatobiliary and Pancreatic Surgery, Dalian Medical University, Dalian, Liaoning, China * These authors contributed equally to this work Correspondence to: Hao-Jun Yang, email: HaoJunYangDoc@hotmail.com Keywords: gallbladder cancer; age at diagnosis; SEER; survival analysis; surgery Received: August 07, 2017      Accepted: December 28, 2017      Epub: January 02, 2018 ABSTRACT This article compares the clinical characteristics and prognosis of patients in different age groups with gallbladder cancer (GBC) treated by surgical resection. We retrospectively studied Surveillance, Epidemiology, and End Results (SEER) population-based data and identified 10,568 patients with GBC who underwent surgical treatment from 1980 to 2013. The patients were categorized according to age at diagnosis: <60 years (young group) or ≥60 years (old group). Five-year cancer-specific survival data were obtained. Kaplan–Meier methods and multivariable Cox regression models were used to analyze long-term survival outcomes and risk factors. Patients in the young group had a higher proportion of white race within-group comparisons, a higher rate of tumors at TNM stage III/IV, a higher frequency of >5-cm tumors, a lower prevalence of a localized SEER stage, a higher number of lymph nodes dissected (≥2 nodes), and a lower proportion of tumors among patients with a widowed marital status, all of which were statistically significant within-group differences ( P < 0.001). Age at diagnosis was an independent prognostic factor in the multivariate analysis ( P < 0.001). The 5-year gallbladder cancer cause-specific survival rate was 26.7% in the young group and 16.2% in the old group, which showed statistical significance in both the univariate and multivariate analysis ( P < 0.001). Conclusions Young patients with GBC treated with surgical resection appear to have unique characteristics and a higher cancer-specific survival rate than older patients, although they showed a higher rate of poor biological behavior and advanced-stage disease.