Prognostic Factors in Patients Diagnosed with Gallbladder Cancer over a Period of 20 Years: A Cohort Study
Abstract
:Simple Summary
Abstract
1. Introduction
2. Methods
3. Results
3.1. Survival
3.2. Cox Proportional Multivariate Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | All N = 331 % | Urban N = 114 % | Rural N = 217 % | p Values |
---|---|---|---|---|
Median age in years | 74 (range: 28–97) | 75 (36–93) | 74 (28–97) | 0.9 |
Men | 33 | 32 | 34 | 0.8 |
Mean BMI (standard deviation) | 28.1 ± 6.0 | 27.4 ± 6.1 | 28.7 ± 6.1 | 0.20 |
Comorbid illness a | 46 | 49 | 44 | 0.54 |
Smoking history b | 45 | 30 | 54 | 0.004 |
Diagnosed before year 2010 | 49 | 43 | 52 | 0.13 |
WHO performance status > 1 c | 40 | 44 | 37 | 0.44 |
Pathological diagnosis | 92 | 97 | 90 | 0.03 |
Stage d | ||||
0 | 5 | 4 | 5 | 0.75 |
I | 8 | 9 | 7 | 0.79 |
II | 13 | 10 | 15 | 0.31 |
III | 11 | 16 | 8 | 0.07 |
IV | 64 | 62 | 65 | 0.77 |
Onset of symptoms to diagnosis in months (mean) e | 9.3 ± 9.0 | 8.3 ± 7.2 | 10.1 ± 10.0 | 0.18 |
Symptom Frequency | ||||
Pain | 83 | 85 | 83 | 1.0 |
Weight loss | 29 | 32 | 27 | 0.4 |
Nausea/Vomiting | 27 | 34 | 21 | 0.08 |
Jaundice | 29 | 27 | 30 | 0.73 |
Oncology consult | 45 | 47 | 44 | 0.56 |
Mean baseline laboratory values | ||||
Mean creatinine | 87 ± 57 | 78 ± 27 | 92 ± 68 | 0.18 |
Mean BUN | 6.3 ± 4.7 | 6.2 ± 3.7 | 6.4 ± 5.2 | 0.77 |
Mean albumin | 33 ± 7 | 31 ± 7 | 34 ± 7 | 0.05 |
Mean bilirubin | 25.6 ± 58 | 20.3 ± 31 | 28.7 ± 69 | 0.22 |
Mean alkaline phosphatase | 253 ± 360 | 233 ± 251 | 264 ± 413 | 0.64 |
Mean AST | 72 ± 126 | 52 ± 86 | 83 ± 143 | 0.28 |
Mean ALT | 59 ± 113 | 54 ± 87 | 62 ± 122 | 0.71 |
Mean WBC | 9.8 ± 5.3 | 9.4 ± 4.0 | 9.9 ± 5.9 | 0.60 |
Mean hemoglobin | 122 ± 19 | 122 ± 20 | 122 ± 18 | 0.97 |
Mean platelets | 312 ± 122 | 341 ± 107 | 296 ± 127 | 0.04 |
Mean NLR | 5.2 ± 4.8 | 5.6 ± 5.0 | 5.0 ± 4.6 | 0.50 |
Stage | Urban a N = 114 % | Rural b N = 217 % | p Value | Year 2000–2009 N = 162 % | Year 2010–2020 N = 168 % | p Value |
---|---|---|---|---|---|---|
0 | 4 | 5 | 1.0 | 8 | 3 | 0.15 |
I | 9 | 7 | 0.52 | 8 | 8 | 1.0 |
II | 10 | 15 | 0.31 | 15 | 12 | 0.41 |
III | 16 | 8 | 0.13 | 4 | 15 | 0.005 |
IV | 62 | 65 | 0.20 | 66 | 63 | 0.43 |
Variables | Univariate Analysis | Multivariate Analysis | ||
---|---|---|---|---|
HR (95% CI) | p Value | HR (95% CI) | p Value | |
Age ≥ 70 years | 1.52 (0.88–2.66) | 0.13 | ||
Men | 1.13 (0.64–2.0) | 0.67 | ||
Urban residence | 1.19 (1.11–3.31) | 0.01 | 2.20 (1.1–4.39) | 0.025 |
No comorbid illness | 1.03 (0.55–1.94) | 0.91 | ||
Positive smoking history | 1.30 (0.70–2.41) | 0.40 | ||
Abnormal body mass index | 1. 15 (0.81–2.80) | 0.20 | ||
Year of diagnosis < 2010 | 1.14 (0.61–2.13) | 0.67 | ||
Stage III disease | 3.1 (1.77–5.56) | <0.001 | 2.63 (1.09–6.34) | 0.032 |
WHO performance status > 1 | 1.17 (0.56–2.44) | 0.68 | ||
No referral to a cancer center | 1.01 (0.52–1.92) | 0.98 | ||
No surgery | 7.30 (1.63–32.45) | 0.009 | ||
No chemotherapy | 1.35 (0.72–2.55) | 0.34 | ||
No radiation | 1.71 (0.80–3.65) | 0.16 | ||
T3 disease | 2.75 (1.56–4.88) | <0.001 | ||
Node-positive disease | 1.14 (0.64–2.02) | 0.65 | ||
Grade 3 tumor | 2.29 (1.31–4.0) | 0.004 | ||
Positive resection margin | 2.06 (1.10–3.86) | 0.024 | ||
Year of diagnosis < 2010 | 1.14 (0.61–2.13) | 0.67 | ||
Albumin < 35 g/L | 1.18 (0.66–2.09) | 0.58 | ||
Creatinine > 100 µm/L | 1.03 (0.61–1.84) | 0.82 | ||
Total bilirubin > 22 µm/L | 1.52 (0.89–2.62) | 0.12 | ||
Alkaline phosphatase > 120 IU/L | 1.73 (0.99–3.04) | 0.056 | ||
AST > 45 U/L | 1.96 (1.05–3.69) | 0.04 | ||
Hemoglobin < 120 g/L | 1.26 (0.73–2.18) | 0.40 | ||
Platelet > 450 × 109 | 1.29 (0.18–9.36) | 0.80 | ||
NLR > 3.2 | 1.22 (0.62–2.39) | 0.56 |
Variables | Univariate Analysis | Multivariate Analysis | ||
---|---|---|---|---|
HR (95% CI) | p Value | HR (95% CI) | p Value | |
Age ≥ 70 years | 1.52 (1.20–1.95) | <0.001 | 1.51 (1.04–2.19) | 0.03 |
Men | 1.17 (0.91–1.95) | 0.20 | ||
Urban residence | 1.15 (0.90–1.47) | 0.25 | ||
Comorbid illness | 1.35 (0.98–1.86) | 0.07 | ||
Positive smoking history | 1.24 (0.88–1.74) | 0.22 | ||
Abnormal body mass index | 1.15 (0.83–1.58) | 0.42 | ||
Year of diagnosis < 2010 | 1.12 (0.88–1.41) | 0.36 | ||
Stage IV disease | 3.8 (2.71–5.41) | <0.001 | 3.02 (1.85–4.94) | <0.001 |
WHO performance status > 1 | 2.62 (1.89–3.61) | <0.001 | ||
No surgery | 3.50 (2.53–4.81) | <0.001 | 1.63 (1.03–2.57) | 0.03 |
No referral to a cancer center | 1.63 (1.29–2.06) | <0.001 | 2.64 (1.51–4.62) | <0.001 |
No chemotherapy | 1.18 (0.87–1.61) | 0.27 | ||
No radiation | 1.28 (0.75–2.13) | 0.37 | ||
Albumin < 35 g/L | 1.79 (1.28–2.49) | <0.001 | ||
Creatinine > 100 µm/L | 1.31 (1.01–1.69) | 0.04 | ||
Total bilirubin > 22 µm/L | 1.59 (1.22–2.06) | <0.001 | ||
Alkaline phosphatase > 120 IU/L | 2.03 (1.44–2.87) | <0.001 | ||
AST > 45 U/L | 1.91 (1.35–2.72) | <0.001 | ||
Hemoglobin < 120 g/L | 1.63 (1.23–2.17) | <0.001 | ||
Platelet > 450 × 109/L | 1.50 (0.92–2.47) | 0.10 | ||
NLR > 3.2 | 1.30 (0.98–1.74) | 0.07 | 1.57 (1.05–2.36) | 0.03 |
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Toussi, N.; Daida, K.; Moser, M.; Le, D.; Hagel, K.; Kanthan, R.; Shaw, J.; Zaidi, A.; Chalchal, H.; Ahmed, S. Prognostic Factors in Patients Diagnosed with Gallbladder Cancer over a Period of 20 Years: A Cohort Study. Cancers 2024, 16, 2932. https://doi.org/10.3390/cancers16172932
Toussi N, Daida K, Moser M, Le D, Hagel K, Kanthan R, Shaw J, Zaidi A, Chalchal H, Ahmed S. Prognostic Factors in Patients Diagnosed with Gallbladder Cancer over a Period of 20 Years: A Cohort Study. Cancers. 2024; 16(17):2932. https://doi.org/10.3390/cancers16172932
Chicago/Turabian StyleToussi, Nima, Krishna Daida, Michael Moser, Duc Le, Kimberly Hagel, Rani Kanthan, John Shaw, Adnan Zaidi, Haji Chalchal, and Shahid Ahmed. 2024. "Prognostic Factors in Patients Diagnosed with Gallbladder Cancer over a Period of 20 Years: A Cohort Study" Cancers 16, no. 17: 2932. https://doi.org/10.3390/cancers16172932