Analysis Of The Prognostic Factors In Patients With Unsuspected Gallbladder Carcinoma

Objective:To investigate the risk factors influencing the prognosis of patients with unsuspected gallbladder cancer.Methods:We reviewed and summarized the clinical pathological data of 94 cases of unsuspected gallbladder cancer in our hospital. All the potential prognostic factors were analyzed. Kaplan-Meier method was used to calculated the survival rate, Log-rank method was used to test the survival rate, and the COX proportional hazard regression model was used for multivariate survival analysis. Independent risk factors were identified.Results:There were 29 males and 65 females in this study of 94 cases of unsuspected gallbladder cancer. A total of 61 cases of simple cholecystectomy,29 cases gallbladder cancer radical surgery,4 cases gallbladder cancer palliative surgery due to the tumor progression and the family refusal of radical surgery. Postoperative pathological examination showed 29 cases of unexpected gallbladder carcinoma in Tla stage,21 cases in T1b period, 28 cases in T2 phase,15 cases in T3 phase, and 1 in T4 period. Among the patients, 91 were followed up, showing that 26 deaths were gallbladder-cancer-related, and 1 was liver-cancer-related; among the survived patients, 2 survived with tumor,62 were tumor-free survival. The 1-,3-,5-year cumulative survival rates were 86.3%,71.7%,68.3%. Single factor survival analysis show that the prognostic factors include age (?60 years old), preoperative diagnosis (association with gallbladder stone), serum CA199 level, type of surgery, intraoperative bile leakage, common bile duct invasion, gallbladder wall thickening, differentiation, depth of invasion (T staging), lymph node metastasis, vascular invasion, perineural invasion, liver invasion and TNM stage. COX regression model analysis showed that age (P=0.002), CA19-9 (P=0.000), bile leakage during operation (P=0.047) and T stage (P=0.000) were independent prognostic factors for shortening survival.Conclusion:Prognosis independent risk factors for the prognosis of unsuspected gallbladder carcinoma are age, CA19-9 level, intraoperative bile leakage and T stage.