Survival Predictors of Resectable Gallbladder Carcinoma: An Analysis of the Surveillance, Epidemiology, and End Results Database

Abstract

Background To analyze population-level data for resectable gallbladder carcinoma (GBC) according to the eighth edition of the American Joint Committee on Cancer staging system. Methods We queried the Surveillance, Epidemiology, and End Results database to identify all patients aged 18 years or older with T1-3 M0 GBC diagnosed between 2004 and 2015. Multivariate cox hazard regression analysis was used to identify prognostic factors of cancer-specific survival (CSS). Results Of the 1601 eligible patients, 1310 (81.8%) underwent cholecystectomy only and 291 (18.2%) underwent an en bloc resection. Overall, 219 (13.7%) patients were in stage I, 400 (25%) were in stage II, 260 (16.2%) were in stage IIIA, 653 (40.8%) were in stage IIIB, and 69 (4.3%) were in stage IVB. The 5-year survival rates for patients were 82.7% for stage I, 73.4% for stage II, 31.9% for stage IIIA, 24.1% for stage IIIB, and 10% for stage IVB. Multivariate cox analysis indicated that predictors of decreased CSS included age at diagnosis >65 years, tumor size >3.2 cm, adenocarcinoma, increasing tumor spread, and lymph node involvement. Besides, chemotherapy and radiation were predictors of increased CSS. Conclusions Older age, increasing tumor size, adenocarcinoma, and advanced tumor/node stage were associated with a poorer prognosis after resection for GBC. Furthermore, patients with resectable GBC can benefit from adjuvant therapy.