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• W2889874146 abstract "Background: Patients with Primary Sclerosing Cholangitis (PSC) have higher incidence of biliary cancer, including gallbladder cancer. The impact of PSC on survival for gallbladder cancer patients is unknown. Methods: Our analysis included 375 patients with gallbladder cancer from a cohort of patients undergoing definitive resection from January 1, 2000 to December 31, 2014 at 10 US academic institutions. Overall survival (OS) was calculated from the date of initial cholecystectomy to the date of death or last follow up, and survival compared in patients with and without PSC. Univariable and multivariable Cox regression analyses were performed to assess OS. Results: Of the patients with gallbladder cancer, ten had a diagnosis of PSC (2.7%). PSC patients were younger (age 57.8 ± 17.9 years vs 65.7 ± 11.1 years, =0.03) with lower overall functional status ( =0.03), and more were male (70% vs 35%, =0.02) compared to gallbladder cancer patients without PSC. No significant differences were observed between ASA class or presence of jaundice pre-operatively. Gallbladder cancer stage was significantly lower in patients with PSC with 40% having Stage 0 or Stage I disease compared with only 7% of the patients without PSC (=0.002). Median follow-up interval for the cohort was 12.3 months. On multivariate analysis including age, functional status, PSC diagnosis and stage, PSC status was not associated with a difference in overall survival. For the entire group, stage remained independently associated with OS (HR 2.11, 95% CI 1.76–2.52, =<0.001). Conclusion: No differences in survival were seen between gallbladder cancer patients with PSC vs without PSC in our cohort. Further studies with greater representation of patients with PSC are needed to determine survival differences, which can help guide treatment decision making.Table 1Predictive factors for overall survival in gallbladder cancerUnivariate analysisMultivariate analysisHR (95% CI)p valueHR (95% CI)p valuePSC0.91 (0.40–2.04)0.8130.76 (0.24–2.43)0.649Age1.01 (1.00–1.03)0.0471.00 (0,99–1.02)0.267Sex1.04 (0.79–1.37)0.7740.85 (0.62–1.16)0.299Race1.00(0.86–1.16)0.986NANAASA class1.54 (1.17–2.01)0.002*NA*NAFunctional status1.28 (0.83–1.97)0.2661.62 (0.96–2.74)0.072Clinical jaundice2.38 (1.75-3.24)<0.0011.61 (1.14–2.28)0.007Extent of Resection1.08(1.00–1.16)0.044NANAFinal margin status2.03 (1.76–2.35)<0.0011.47 (1.19–1.81)<0.001Any complication1.87 (1.43–2.46)<0.0011.59 (1.17–2.17)0.003AJCC stage2.09 (1.76–2.50)<0.0012.11 (1.76–2.52)<0.001Grade1.54 (1.20–1.98)0.001*NA*NALymph node positive1.90(1.35–2.67)<0.001*NA*NARecurrence4.96 (2.98–8.26)<0.001NANAHR = Hazard Ratio; CI = Confidence Interval; *Variables excluded from multivariate analysis due to missing data for >20% of patients. Remaining variables selected for multivariate analysis were those found to be significantly different between patients with PSC vs without PSC and/or significant for overall survival on univariate analysis Open table in a new tab HR = Hazard Ratio; CI = Confidence Interval; *Variables excluded from multivariate analysis due to missing data for >20% of patients. Remaining variables selected for multivariate analysis were those found to be significantly different between patients with PSC vs without PSC and/or significant for overall survival on univariate analysis" @default.
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• W2889874146 date "2018-03-01" @default.
• W2889874146 modified "2023-09-28" @default.
• W2889874146 title "Is primary sclerosing cholangitis-related gallbladder cancer associated with worse survival? Results from the U.S. extrahepatic biliary malignancy consortium" @default.
• W2889874146 doi "https://doi.org/10.1016/j.hpb.2018.02.293" @default.
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