Macroscopic Inflammation Status of Resected Gallbladder Predicts Therapeutic Outcome After Radical Resection for Gallbladder Carcinoma

Abstract

Objective Gallbladder carcinoma (GBC) is one of the digestive cancers with poor prognosis, for which surgical resection is the only potentially curative therapy. Prognostic value of macroscopic inflammatory status of the resected gallbladder in patient with GBC has not been fully investigated. We retrospectively investigated the relation between macroscopic inflammatory status and disease-free as well as overall survival after radical resection for GBC. Method The subjects were 44 patients who underwent radical resection for GBC between January 2004 and April 2011 at Jikei University Hospital. We retrospectively investigated the relationship between clinicopathologic variables, including macroscopic inflammatory status and disease-free as well as overall survival. Results In univariate analysis, disease-free survival was poor in patients with Tumor-Nodes-Metastasis (TNM) stage ≥III (P < 0.0001) and positive vascular invasion (P = 0.0001). Patients with macroscopic chronic inflammation tended to have poor disease-free survival than those with normal type (P = 0.0930). Overall survival was poor in patients with TNM stage ≥III (P < 0.0001), presence of intraoperative blood transfusion (P = 0.0125), positive vascular invasion (P = 0.0055), and macroscopic chronic inflammation (P = 0.0281). In multivariate analysis, TNM stage ≥III (P < 0.0114) and macroscopic chronic inflammation (P = 0.0350) were independent predictors of disease-free survival. For overall survival, TNM stage ≥III (P = 0.0054) and macroscopic chronic inflammation (P = 0.0124) were the independent predictors. Moreover, macroscopic chronic inflammation correlated with the presence of gallstones. Conclusion The macroscopic Inflammation status of resected gallbladder cancer correlates with oncologic outcome in patients with GBC treated by radical resection.