We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Prognostic Factors in Patients Diagnosed with Gallbladder Cancer over a Period of 20 Years: A Cohort Study.
- Authors
Toussi, Nima; Daida, Krishna; Moser, Michael; Le, Duc; Hagel, Kimberly; Kanthan, Rani; Shaw, John; Zaidi, Adnan; Chalchal, Haji; Ahmed, Shahid
- Abstract
Simple Summary: This study examined the outcomes of patients with gallbladder cancer over 20 years in Saskatchewan, Canada, focusing on geographic, demographic, and clinical factors. A total of 331 patients diagnosed between 2000 and 2019 were included. The majority (64%) had advanced stage 4 disease, with a significant proportion (66%) being rural residents. Key factors associated with poorer overall survival included stage 4 disease, lack of surgery, older age, a higher neutrophil-to-lymphocyte ratio, and no referral to a regional cancer center. Among early-stage patients, stage III disease and urban residence were associated with worse disease-free survival. The findings highlight the late-stage diagnosis and referral challenges impacting the outcomes of gallbladder cancer. Background: Gallbladder cancer (GBC) is an uncommon cancer. This study aimed to determine the outcomes of GBC in relation to geographic, demographic, and clinical factors in a Canadian province from 2000 to 2019. Methods: This population-based retrospective cohort study included all patients diagnosed with gallbladder cancer (GBC) in Saskatchewan, Canada, from 2000 to 2019. Cox proportional multivariate regression analysis was conducted to identify factors associated with poorer outcomes. Results: In total, 331 patients with a median age of 74 years and male–female ratio of 1:2 were identified. Of these patients, 305 (92%) had a pathological diagnosis of GBC. Among patients with documented staging data, 64% had stage IV disease. A total of 217 (66%) patients were rural residents, and 149 (45%) were referred to a cancer center. The multivariate analysis for patients with stage I–III GBC showed that stage III disease [hazard ratio (HR), 2.63; 95% confidence interval (CI), 1.09–6.34)] and urban residence (HR, 2.20; 95% CI, 1.1–4.39) were correlated with inferior disease-free survival. For all patients, stage IV disease (HR, 3.02; 95% CI, 1.85–4.94), no referral to a cancer center (HR, 2.64; 95% CI, 1.51–4.62), lack of surgery (HR, 1.63; 95% CI, 1.03–2.57), a neutrophil–lymphocyte ratio of >3.2 (HR, 1.57; 1.05–2.36), and age of ≥70 years (HR, 1.51; 95% CI, 1.04–2.19) were correlated with inferior overall survival. Conclusions: In this real-world context, the majority of patients with GBC were diagnosed at a late stage and were not referred to a cancer center. For those with early-stage GBC, living in an urban area and having stage III disease were linked to worse outcomes. Across all stages of GBC, stage IV disease, older age, absence of surgery, lack of referral to a cancer center, and a high neutrophil-to-lymphocyte ratio were associated with poorer survival.
- Subjects
SASKATCHEWAN; GALLBLADDER tumors; CANCER treatment; NEUTROPHIL lymphocyte ratio; RESEARCH funding; EARLY detection of cancer; TREATMENT effectiveness; POPULATION geography; CANCER patients; RETROSPECTIVE studies; MULTIVARIATE analysis; AGE distribution; LONGITUDINAL method; OPERATIVE surgery; CANCER chemotherapy; RURAL conditions; METROPOLITAN areas; TUMOR classification; CONFIDENCE intervals; PROGRESSION-free survival; TIME; PROPORTIONAL hazards models; REGRESSION analysis; SPECIALTY hospitals; OVERALL survival; MEDICAL referrals
- Publication
Cancers, 2024, Vol 16, Issue 17, p2932
- ISSN
2072-6694
- Publication type
Article
- DOI
10.3390/cancers16172932