Factors that contribute to five year survival of gallbladder cancer patients
Abstract
Introduction: Gallbladder cancer (GBC) is an uncommon malignancy of the biliary tract with
a poor prognosis frequently presenting at an advanced stage. Generally, GBC is the most
aggressive of the biliary tract cancers accounting for 80-95% of this malignancy’s. In addition,
it has the shortest median survival duration. Early diagnosis is crucial for improved prognosis.
However, indolent and non-specific clinical presentations with a paucity of pathognomonic
radiological features often preclude accurate recognition of GBC at an early stage. There is
limited documented evidence on the survival and associated factors to guide effective
management of GBC patients at KNH.
Objectives: This study aims to determine five-year survival and associated factors leading to
death of gallbladder cancer patients seen at KNH
Methodology: The study was a retrospective cohort study of all patients who had a diagnosis
of primary GBC and were seen at KNH. The sample size was all patients diagnosed with GBC
seen at KNH. Data collected was age, sex, time of diagnosis (pre-op, intra-op), stage of
cancer, type of cancer and treatment (surgery, chemotherapy, radiotherapy) given to the
patients and it was abstracted from patients’ records. Data was analyzed using STATA version
15. Cox regression approach was used to evaluate these factors.
Results: The median survival time for GBC patients is 7.29 months with an interquartile of
2.4-36.75 months. The incidence rate of death among these patients was 7% in a month.
There was no significant difference between the predictor variables of age (p=0.769), gender
(p=0.548), time of diagnosis (p=0.742), type of GBC (0.494), advanced stage (p=0.813),
treatment (p=0.063) on time to death. However, those with advanced stage had a 12%more
chance of dying. Participants who underwent surgery and chemotherapy survived longer.
Conclusion: The study established that there was no statistical difference on the predictor
variables to time to death on GBC patients. However, late diagnosis leads to finding the
malignancy already in its advanced stage hence curative surgery not possible.
Consequently, patients who underwent combined treatment of surgery and chemotherapy
management had a longer survival.
Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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