title: Preoperative Systemic Inflammation and Complications Affect Long-term Gallbladder Carcinoma Outcomes Following Surgery with Curative Intent.
abstract: Gallbladder carcinoma (GBCA) has extremely poor outcomes. We aimed to investigate clinicopathological prognostic variables, including the modified Glasgow prognostic score (mGPS), for patients with resected GBCA.
  
  
  
  This retrospective study included 54 patients with GBCA resected between 1996 and 2014. Univariate and multivariate analyses were performed to identify prognostic factors associated with overall and recurrence-free survival.
  
  
  
  Curative resection (R0) was achieved in 43 patients (79.6%). The median patient age was 74 years (range=25-99 years), and the majority (n=33, 61.1%) were women. Incidental GBCA was detected in 18 patients (33.3%). The overall and recurrence-free survival rates were 63.3% and 55.8% at 3 years and 58.4% and 51.3% at 5 years, respectively. In multivariate analysis, postoperative intra-abdominal complications (p=0.015), non-curative resection (p=0.008), worse histological type (p=0.003), and elevated mGPS (p=0.002) were independent predictors of worse overall survival. Surgical complications (p=0.015), non-curative resection (p=0.005), worse histological type (p=0.002), and elevated mGPS (p=0.022) were also independent predictors of worse recurrence-free survival.
  
  
  
  Curative resection was important for long-term survival for GBCA. A high preoperative mGPS and occurrence of surgical complications were independent prognostic indicators of poor survival in GBCA.
authors.affiliation: Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Abe
authors.affiliation: Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima, Japan Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan amanojack@star.odn.ne.jp.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Amano
authors.affiliation: Department of Gastroenterology, Onomichi General Hospital, Onomichi, Hiroshima, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Hanada
authors.affiliation: Department of Pathology, Onomichi General Hospital, Onomichi, Hiroshima, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Yonehara
authors.affiliation: Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Surgery, Hiroshima General Hospital of West Japan Railway Company, Hiroshima, Japan.
authors.forename: Toshikatsu
authors.initials: T
authors.lastname: Fukuda
authors.affiliation: Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakahara
authors.affiliation: Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kuroda
authors.affiliation: Department of Surgery, Onomichi General Hospital, Onomichi, Hiroshima, Japan Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Noriyuki
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005706:Gallbladder Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000473:pathology*; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Gallbladder carcinoma; modified Glasgow prognostic score; postoperative complication; survival