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2008 Annual Meeting Abstracts
Trends in Presentation and Survival for Gallbladder Cancer Over More Than Four Decades. A Single Institution Experience
Ioannis Konstantinidis, MD, David Berger, MD, Carlos Fernandez-del Castillo, MD, Kenneth Tanabe, MD, Cristina Ferrone, MD.
Massachusetts General Hospital, Boston, MA, USA.
Objective
To analyze the changes in the mode of presentation, treatment and survival for gallbladder cancer patients over four decades
Design
Retrospective case-series
Setting
University-affiliated referral center
Patients
Between 1/1962-3/2008 395 patients with gallbladder cancer were identified and their clinicopathologic data was analyzed.
Interventions
Surgical treatment, radiotherapy, chemotherapy.
Main Outcome Measures
Differences in the stage of disease at presentation, type of treatment received and survival were compared between three time periods (A:1962-1979, B:1980-1997, C:1998-2008).
Results
For our cohort of 395 patients the median age was 71 years (range 11-98) and 70% were female. Surgical exploration was performed in 236 (60%) of whom 138 (35%) had their tumor resected. Median survival for all patients was 6 months and for resected patients was 11 months. While the majority of patients present with stage IV disease (A:41%, B:38%, C:49%) with a median survival of 3 months (range 0-37 months), the number of stage I patients has increased (A:19%, B:21%, C:30%). Concomitant liver resections increased (A:9%, B:12%, C:40%) with a subsequent increase in negative margins (A:27%, B:36%, C:62%). Adjuvant therapy was received by 28% of patients (period A:6%, B:23%, C:38%). Log rank identified stage and negative margins as significant prognostic factors.
Conclusions
The prognosis of patients with gallbladder cancer is improving which may be associated with earlier detection and more extensive operations. However, most of the patients still present with incurable disease for which survival is very poor. Efforts should focus on early recognition of this aggressive malignancy.
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