Masters
Research Project by Dr. Alice W. Maingi
W62/63975/2010
University
of Nairobi
ABSTRACT
Introduction: Gallbladder cancer (GBC) is an uncommon malignancy of the biliary tract
with a poor prognosis frequently presenting at an advanced stage. Generally,
GBC is the most aggressive of the biliary tract cancers accounting for 80-95%
of this malignancy's. In addition, it has the shortest median survival
duration. Early diagnosis is crucial for improved prognosis.
However, indolent and non-specific clinical presentations with a paucity of pathognomonic radiological features often preclude accurate recognition of GBC at an early stage. There is limited documented evidence on the survival and associated factors to guide effective management of GBC patients at KNH.
However, indolent and non-specific clinical presentations with a paucity of pathognomonic radiological features often preclude accurate recognition of GBC at an early stage. There is limited documented evidence on the survival and associated factors to guide effective management of GBC patients at KNH.
Objectives:
This study aims to determine five-year survival and associated factors
leading to death of gallbladder cancer patients seen at KNH.
Methodology: The study was a retrospective cohort study of all patients who had a
diagnosis of primary GBC and were seen at KNH. The sample size was all patients
diagnosed with GBC seen at KNH. Data collected was age, sex, time of diagnosis
(pre-op, intra-op), stage of cancer, type of cancer and treatment (surgery,
chemotherapy, radiotherapy) given to the patients and it was abstracted from
patients' records. Data was analyzed using STATA version 15. Cox regression
approach was used to evaluate these factors.
Results: The median survival time for GBC patients is 7.29 months with an
interquartile of 2.4-36.75 months. The incidence rate of death among these
patients was 7% in a month.
There was no significant difference between the predictor variables of age (p=0.769), gender (p=0.548), time of diagnosis (p=0.742), type of GBC (0.494), advanced stage (p=0.813), treatment (p=0.063) on time to death. However, those with advanced stage had a12%more chance of dying. Participants who underwent surgery and chemotherapy survived longer.
There was no significant difference between the predictor variables of age (p=0.769), gender (p=0.548), time of diagnosis (p=0.742), type of GBC (0.494), advanced stage (p=0.813), treatment (p=0.063) on time to death. However, those with advanced stage had a12%more chance of dying. Participants who underwent surgery and chemotherapy survived longer.
Conclusion: The study established that there was no statistical difference on the
predictor variables to time to death on GBC patients. However, late diagnosis
leads to finding the malignancy already in its advanced stage hence curative
surgery not possible.
Consequently, patients who underwent combined treatment of surgery and chemotherapy management had a longer survival.
Consequently, patients who underwent combined treatment of surgery and chemotherapy management had a longer survival.
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