Prognosis Remains Poor in Gallbladder Cancer

Since 1962, median survival at Massachusetts General Hospital increased from 3.5 to 12 months

WEDNESDAY, May 20 (HealthDay News) -- Median survival time for patients with gallbladder cancer has increased for more than four decades, but many patients still present with advanced disease and prognosis remains poor, according to a paper in the May Archives of Surgery.

Ioannis T. Konstantinidis, M.D., of Massachusetts General Hospital in Boston, and colleagues reviewed data on 402 patients (mean age of 72 years) with gallbladder cancer who presented at the hospital between 1962 and 2008. The researchers analyzed data on disease presentation, interventions (surgery, chemotherapy and radiotherapy), residual disease, and survival. Trends over three periods -- 1962 to 1979 (A), 1980 to 1997 (B), and 1998 to 2008 (C) -- were identified.

Over the study period, the researchers found that non-surgical therapies increased (A, 18.1 percent; B, 22.8 percent; C, 45.8 percent), while palliative surgery declined (A, 19.3 percent; B, 24.8 percent; C, 9.7 percent). For patients who had their tumor surgically removed, operative mortality decreased (A, 8.4 percent; C, 1.4 percent). Overall, median survival increased but remained short (A, 3.5 months; B, 6.5 months; C, 12 months), the authors note. In all three periods, more advanced stage of disease was associated with shorter survival time.

"Patients with gallbladder cancer continue to have a poor prognosis because many of the patients present with advanced disease. Earlier detection coupled with an aggressive surgical approach leads to better outcomes," the authors conclude. "A better understanding of the molecular pathways contributing to the development of gallbladder cancer is needed to develop improved adjuvant therapies to increase overall survival."

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