PREDICTORS OF SURVIVAL IN PATIENTS WITH CARCINOMA OF THE GALLBLADDER

Background. The role of resectional surgery in patients with advanced stages of gallbladder carcinoma has not been fully defined. It is gene rally believed that the survival depends on the stage of the disease, rather than on the treatment option. Methods. Seventeen selected risk factors were analyzed using univariate and multivariate analyses to pr edict survival in 87 patients with gallbladder carcinoma who had under gone some form of surgical treatment. Similarly, a subset of 55 patien ts with American Joint Committee on Cancer Stage IV disease also was a nalyzed separately. Results. Palpable mass, tumor (T) status, local in filtration, lymph node involvement, distant metastasis, TNM stage, and the type of surgical treatment (laparotomy alone, bypass, or resectio n) were significant risk factors by univariate analysis. In addition t o palpable mass and the type of surgical treatment, age was also a sig nificant predictor of survival by multivariate analysis. Multivariate analysis of patients with Stage IV disease revealed the same three fac tors to be significant. In this subset of patients, the median surviva l after resectional surgery was 16.3 months; after biliary and/or gast ric bypass, 4.8 months; and after laparotomy alone, 1.6 months. Conclu sions. The type of surgical treatment significantly influenced surviva l. Resectional surgery was associated with better survival compared wi th biliary and/or gastric bypass or laparotomy alone for patients with all stages of the disease, including those with advanced carcinoma of the gallbladder.