title: Survival of a cohort of patients with intermediate and advanced gall bladder cancer treated with a prospective therapeutic protocol.
abstract: OBJECTIVE
  To evaluate the results of a prospective therapeutic protocol with long-term follow up in terms of survival rates in a cohort of patients treated with Intermediate and Advanced GBC (GBC).
  
  
  METHODS
  Prospective cohort of patients with intermediate and advanced stages of GBC treated between 1996 and 2006. All cases were treated with a partial hepatic segmentectomy on segments IVb and V and a regional lymph node dissection and six cycles of out-patient chemotherapy (5-FU and leukovorin). With an average follow-up of 31.5 months, the morbidity, operative mortality, hepatic and lymphatic infiltration and actuarial survival were measured. Descriptive statistics were applied as well as bivariate analysis applying Fisher's exact test and non-parametrical tests and Kaplan Meier survival curves. Also logistic regression and proportional risk of Cox were applied.
  
  
  RESULTS
  40 patients were included in this protocol, with an average age of 59.5 years (40-85 years), of which 28 were women (70%). Depth of wall infiltration: muscular 8 patients (20%), subserosal 12 patients (30%), serosal 12 patients (30%) and perivesicular adipose tissue 8 patients (20%). The series morbidity was 27.5%. There was no operative mortality. The chemotherapy was well tolerated. The overall actuarial survival in the series was 50% at 60 months.
  
  
  CONCLUSIONS
  Our protocol treatment has morbidity, mortality and survival rates similar to previously reported series.
authors.affiliation: Department of Surgery, Universidad de La Frontera, Temuco, Chile. cmantero@ufro.cl <cmantero@ufro.cl>
authors.forename: Carlos
authors.initials: C
authors.lastname: Manterola
authors.forename: Manuel
authors.initials: M
authors.lastname: Vial
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Roa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002277:Carcinoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D002677:Chile / Q000453:epidemiology; D002763:Cholecystectomy / Q000379:methods; D002985:Clinical Protocols; D004812:Epidemiologic Methods; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D005706:Gallbladder Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012737:Sex Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D002955:Leucovorin; D005472:Fluorouracil