Who benefits from R0 resection? A single-center analysis of patients with stage Ⅳ gallbladder cancer

• Published in: Chronic diseases and translational medicine 2019-09, Vol.5 (3), p.188-196
• Main Authors: Chen, Chen, Wang, Lin, Zhang, Rui, Li, Qi, Zhao, Ya-Ling, Zhang, Guan-Jun, Li, Wen-Zhi, Geng, Zhi-Min
• Format: Article
• Language: English
• Subjects: Gallbladder cancer; Original; Prognosis; Surgery; Tumor-node-metastasis (TNM) stage
• ISSN: 2095-882X; 2589-0514; 2589-0514
• DOI: 10.1016/j.cdtm.2019.08.004

Most patients with gallbladder cancer (GBC) present with advanced-stage disease and have a poor prognosis. Radical resection remains the only therapeutic option to improve survival in patients with GBC. This study aimed to analyze the prognostic factors in patients with stage Ⅳ GBC and to identify a subgroup of patients who might benefit from R0 resection. A total of 285 patients with stage Ⅳ GBC were retrospectively analyzed at our institution from January 2008 to December 2012. Factors potentially influencing the prognosis of GBC after surgery were analyzed by univariate and multivariate analyses. The 1-, 3-, and 5-year overall survival rates were 6.6% (15/229), 0.9% (2/229), and 0 (0/229), respectively. Ascites (relative risk [RR] = 1.631, 95% confidence interval [CI]: 1.221–2.180, P = 0.001), pathological grade (RR = 1.337, 95% CI: 1.050–1.702, P = 0.018), T stage (RR = 1.421, 95% CI: 1.099–1.837, P = 0.000), M stage (RR = 1.896, 95% CI: 1.409–2.552, P = 0.000), and surgery (RR = 1.542, 95% CI: 1.022–2.327, P = 0.039) were identified as independent risk factors influencing prognosis. The median survival time (MST) was significantly higher in patients undergoing R0 resection than in those undergoing R1/R2 resection (6.0 vs. 2.7 months; P