Clinical Analysis Of 64 Cases Of Primary Gallbladder Carcinoma

ObjectiveThe study is to investigate the clinical features of the primary gallbladder carcinoma and analyze the association of clinical data with prognosis. Furthermore, we explore the treatment of aged patients and patients in advanced disease.MethodsWe investigated the clinical data of 64 cases with primary gallbladder carcinoma in Shandong Provincial Hospital retrospectively. Then we analyzed the association of gender, age (aged group, non-aged group), clinical symptoms (group with abdominal pain and jaundice, group without abdominal pain and jaundice), tumor markers(CA199, CA125, CEA), surgical approaches(radical group, palliative group), Nevin stage(Ⅰ,Ⅱ,Ⅲ,Ⅳ,Ⅴ stage), tissue differentiation(low differentiation group, high differentiation group), pathological types(adenocarcinoma group, non-adenocarcinoma group), lymph node metastasis with the prognosis using SPSS software. At the same time we evaluated the independent risk factors affecting the prognosis using COX regression analysis. Moreover, we analyzed the effect of surgical approaches on aged patients and patients in advanced disease.ResultsThere were 30 male patients (46.9%) and 34 female patients (53.1%). The ratio of female and male was 1.13. The median age of 64 cases was 65 years old. There were no specific symptoms among these patients with primary gallbladder carcinoma. In addition, patients in Nevin IV and V stage accounted for 70 percent of the 64 cases. The univariate analysis of the clinical data from the 64 cases with primary gallbladder carcinoma showed that age, surgical approaches, Nevin stage, tissue differentiation and lymph node metastasis were significantly correlated with the prognosis of the gallbladder carcinoma patients(P values were 0.001,less than 0.001,0.007,less than 0.001,0.007 respectively). However, gender, clinical symptoms, tumor markers and pathological types had no relationships with the prognosis of the patients with P values were all greater than 0.05. The Cox regression analysis showed that age, surgical approaches, tissue differentiation and lymph node metastasis were the independent risk factors affecting the prognosis. What’s more, the prognosis of the aged patients and advanced patients who were given radical operations were better than those who were given palliative operations.ConclusionsThere were no specific symptoms in the patients with the primary gallbladder carcinoma. Most patients with primary gallbladder carcinoma were old people. Gender, clinical symptoms, tumor markers and pathological types were not significantly correlated with the prognosis. However, prognosis had significant relationships with age, surgical approaches, Nevin stage, tissue differentiation and lymph node metastasis. What’s more, age, surgical approaches, tissue differentiation and lymph node metastasis were the independent risk factors of prognosis. Patients in advanced stage should be given radical operations to have better prognosis. Similarly, radical operations should also be performed in aged patients with good general condition.