Prognostic factors in gallbladder and biliary tract cancer.

Background: Cancers of the gallbladder and bile ducts are uncommon neoplasms with poor survival. Prognostic factors are not well defined because of the scant number of patients reported through series of cases.

Methods: We reviewed the medical records of patients with cancer of the bile ducts and gallbladder between the years 1979 and 1998, and analyzed their characteristics according to location (gallbladder, extrahepatic biliary tract, intrahepatic biliary tract, and Klatskin tumors).

Results: One hundred and sixty-eight patients were included; the mean follow-up time was 238 +/- 54 d. The tumor found at more advanced stages was the biliary tract tumor. Overall survival time was 254 +/- 40 d. Location did not influence survival. The factors significantly associated to increased survival were age at diagnosis less than 50 yr (p = 0.0065), surgical treatment (p < 0.001), adjuvant chemotherapy and radiotherapy (p < 0.001 and p = 0.0072, respectively), surgical treatment with curative purpose (p < 0.001), stage of the disease (p < 0.0001), absence of jaundice (p = 0.0425), and absence of weight loss (p = 0.0446). In the multivariate analysis the significant variables were age, surgical treatment, adjuvant chemotherapy, surgery with curative purpose, stage of the disease, and absence of jaundice.

Conclusions: Cancers of the bile ducts are neoplasms known to have a poor prognosis. Chemotherapy was an independent survival factor despite the context, there is need of future studies to define its role on this disease.