title: [Prognostic factor in gallbladder cancer].
abstract: BACKGROUND
  Gallbladder cancer is a rare and aggressive neoplasm.
  
  
  OBJECTIVE
  The purpose of this manuscript was to evaluate the prognostic factors associated with overall survival in gallbladder cancer patients.
  
  
  METHODS
  We performed a retrospective study of the patients with gallbladder cancer who received attention in a tertiary referral center in Mexico City during a 13 year period (1990-2002). We evaluated demographic, clinical, pathological and treatment variables. The main outcome variable was overall survival. The survival curves were constructed with the Kaplan and Meier method and compared with the log-rank test. Multivariate analyses was performed with the Cox regression method. We considered significant p < 0.05.
  
  
  RESULTS
  Fifty-one patients were registered, 35 of them women (69%). Median patient age was 63 years. Fifty-seven percent of patients had previous diagnosis of cholelithiasis. Seventy-one percent of patients underwent surgery. Ninety-eight percent of the tumors were adenocarcinoma and 25% were poorly differentiated. Eighty-six percent were found to have stage IV. Median survival for the entire cohort was six months (95% CI 0.5-7), and actuarial survival at one and three years was 22.7% and 3.9% respectively. On univariate analysis surgery, early stage, chemotherapy, Karnofsky 2 80 and serum albumin > 3.0 g/dL were associated with better prognosis. On multivariate analysis, only surgery (p = 0.0001) and serum albumin > 3 g/dL (p = 0.002) remained significantly associated with better outcome.
  
  
  CONCLUSIONS
  Most cases of gallbladder cancer presented with advanced stage. Serum albumin is a prognostic factor for survival in this group of patients.
authors.affiliation: Departamento de Cirugía, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México.
authors.forename: Heriberto
authors.initials: H
authors.lastname: Medina-Franco
authors.forename: Guillermo
authors.initials: G
authors.lastname: Ramos-Gallardo
authors.forename: Héctor
authors.initials: H
authors.lastname: Orozco-Zepeda
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Mercado-Díaz
mesh_terms: D005260:Female; D005706:Gallbladder Neoplasms / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate