title: Post-operative lymphocyte count may predict the outcome of radical resection for gallbladder carcinoma.
abstract: BACKGROUND
  Gallbladder carcinoma (GBC) is a cancer of the digestive tract with poor prognosis, for which surgical resection is the only potentially curative therapy. The prognostic value of postoperative peripheral blood leukocyte subset count in patients with cancer has not been fully investigated. Therefore, we retrospectively investigated the relation-ship between postoperative peripheral blood lymphocyte count and disease-free as well as overall survival after radical resection of GBC.
  
  
  METHODS
  The study subjects were 34 patients who underwent radical resection for GBC between January 2005 and April 2010. We retrospectively investigated the relation-ship between clinicopathological variables, including postoperative peripheral blood lymphocyte count, and disease-free as well as overall survival.
  
  
  RESULTS
  In univariate analysis, disease-free survival was worse in patients with intraoperative blood transfusion (p=0.0285), tumor node metastasis (TNM) stage ≥II (p<0.0001), and lymphocyte count of less than 1,000/μl (p=0.0002). Overall survival was worse in patients with TNM stage ≥II (p=0.0002) and lymphocyte count of less than 1,000/μl (p=0.0151). In multivariate analysis, TNM stage ≥II (p<0.0089) and peripheral blood lymphocyte count of less than 1,000/μl (p=0.0365) were independent predictors of poor disease-free survival. For overall survival, TNM stage ≥II (p=0.0230) was the only independent predictor. Moreover, lymphocyte counts of less than 1,000/μl correlated significantly with TNM stage ≥II, duration of operation, greater blood loss, and presence of intraoperative blood transfusion.
  
  
  CONCLUSIONS
  Postoperative peripheral blood lymphocyte count correlates with outcome of patients with GBC treated by radical resection.
authors.affiliation: Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo 105-8461, Japan. ryotaiwa@jikei.ac.jp
authors.forename: Ryota
authors.initials: R
authors.lastname: Iwase
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shiba
authors.forename: Koichiro
authors.initials: K
authors.lastname: Haruki
authors.forename: Yuki
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Kenei
authors.initials: K
authors.lastname: Furukawa
authors.forename: Yasuro
authors.initials: Y
authors.lastname: Futagawa
authors.forename: Shigeki
authors.initials: S
authors.lastname: Wakiyama
authors.forename: Takeyuki
authors.initials: T
authors.lastname: Misawa
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Yanaga
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D005706:Gallbladder Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D016896:Treatment Outcome
keywords: Gallbladder carcinoma; lymphocyte count; operation; prognosis