"Analyzing Survival Predictors and Treatment Strategies in Gallbladder Cancer: A Comprehensive Survival Analysis Study": Single center experience over 10 years

Abstract

Abstract Background/ Aims Gallbladder cancer (GBC) known for its grim prognosis. A multitude of factors exert influence on the outcomes. Combining diverse treatment approaches holds promise for survival benefit. This study aims to analyse prognostic factors of GBC, feasibility of neoadjuvant chemotherapy (NACT) and outcome of incidental tumors. Methods Retrospective analysis of operated patients between 2012 and 2022, and prospective analysis of patients who received NACT. Information on demographics, treatment, histopathology, and follow-up collected. Categorical and continuous variables assessed using log-rank test and Cox proportional hazard analysis, respectively. p-value of < 0.05 was considered significant. Results Of 127 patients, 40 patients were from NACT group. Of 94 patients who underwent surgery, 7 patients (Response rate 17.5%) from NACT group. Median follow-up period was 31 months, Forty six patients (56%) had disease recurrence. Estimated 1and 3year DFS rates were 73% and 47%, respectively. The median OS was 58, 46, 22 and 11 months in Stage I, II, III, and IV respectively. Inferior OS and DFS were seen with Node positive tumour, pT3/T4 tumour, perineural invasion (PNI), Lymphovascular invasion (LVI) and tumour differentiation. Incidental tumours didn’t show no survival difference compared to primary GBC cases. Conclusion NACT necessitates improvement in patient selection and refinement of effective regimens through further randomized controlled trials (RCTs). Factors such as Stage, Nodal spread, LVI and PNI influence OS and DFS. Embracing a multimodal approach for GBC holds promise for enhancing patient survival. Notably, the timing of surgery for incidental GBC has shown to yield improved outcomes.