Hospital Clinico Universidad de Chile, Santiago, Chile
Luis Villanueva , Rodrigo Uribe , Olga Barajas , Barbara Nuñez , Alex Renner , Rodrigo Vasquez , Oscar Aguilera , Renato Muñoz , Monica Ahumada
Background: Chile is the country with highest incidence and mortality rates of the GBC in the world. The GBC is an aggressive cancer with poor survival. Many studies include GBC in the group of biliary tract cancers, but the study as its own entity has been limited. The aim of this study is to evaluate the prognostic factors associated with overall survival (OS) in patients (pts) with the diagnosis of GBC. Methods: Retrospective study that includes pts with diagnosis of GBC confirmed by biopsy, classified according to images or surgical procedures. They were treated in Hospital Clinico Universidad de Chile between January 2010 to December 2015. The analysis was according to demographic, clinical and pathological variables and related to chemotherapeutic treatment (CT). Results: There were 130 pts, 82 women and 48 men. The mean age was 63 (35-96) years. Histopathological diagnosis was adenocarcinoma NOS in 67% of the cases. Seventy-one pts (56%) debuted with IV stage disease. Twenty-one pts (27,6%) received first line of CT. 90% of this pts received gemcitabine with cisplatin, mean cycles was 5.5 (1-19) cycles. OS of stage IV group that received first line CT was 13.6 months (ms) vs 4,2 ms in pts not treated with CT (HR: 0,58, 95% CI 0,35-0,95, p = 0,04). There were 18 pts with stage IIIA and 13 pts with stage IIIB. They did not present statistical significant (ns) in OS (10,9 vs 8,1 ms, respectively, p = ns). Only 5 pts received adjuvant treatment. Our analysis showed factors that determined a better OS were ECOG 0-1 vs ≥ 2 with OS 10 vs 2,2 ms (HR 0.38, 95% CI 0,18-0,79; p = 0,0001). Albumin ≥3,5 showed better OS than albumin < 3,5 g/dl (OS 9,1 vs 5,6 ms; p = ns). The women treated with CT had a superior OS than men (17,2 versus 13,5 ms; p = ns). There were not statistically differences in the OS according to gender, BMI, hemoglobin nor age in all group. Conclusions: In our analysis, pts with ECOG 0-1 and levels of albumin ≥3,5 g/dl demonstrated a better OS due to good functional and nutritional status. Women who received chemotherapy had a better prognosis. Perhaps, this finding is due to early consultation. The absence of adjuvant therapy could explain the poor results obtained in stage III pts.
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