Table 3.
Univariate and multivariate analysis of variables associated with disseminated or unresectable disease in patients with incidental gallbladder cancer submitted to re-exploration
| Variable | All patients (n = 136) | Non-DD group (n = 117) n (%) | DD group (n = 19) n (%) | P-value, univariate | P-value, multivariate | Hazard ratio | 95% CI |
|---|---|---|---|---|---|---|---|
| Gender | 0.53 | ||||||
| Female | 93 | 82 (88.2) | 11 (11.8) | ||||
| Male | 43 | 35 (81.4) | 8 (18.6) | ||||
| Age, years | 0.2 | ||||||
| Mean ± standard deviation | 64 ± 11 | 64 ± 10 | 67 ± 14 | ||||
| Median (range) | 65 (28–90) | 65 (28–85) | 63 (40–90) | ||||
| Presentation of disease | 0.97 | ||||||
| Abdominal pain | 126 | 108 (85.7) | 18 (14.3) | ||||
| Abnormal study | 7 | 6 (87.7) | 1 (12.3) | ||||
| Jaundice | 1 | 1 (100) | 0 | ||||
| Nausea | 1 | 1 (100) | 0 | ||||
| Pancreatitis | 1 | 1 (100) | 0 | ||||
| Gallstones on pre-cholecystectomy US | 0.066 | ||||||
| Yes | 91 | 82 (90.1) | 9 (9.9) | ||||
| No | 45 | 35 (77.8) | 10 (22.2) | ||||
| GB wall thickening on pre-cholecystectomy US | 0.016 | ||||||
| Yes | 32 | 23 (71.9) | 9 (28.1) | ||||
| No | 104 | 94 (89.6) | 10 (10.4) | ||||
| Acute cholecystitis | 0.4 | ||||||
| Yes | 87 | 73 (83.9) | 14 (16.1) | ||||
| No | 48 | 43 (89.6) | 5 (10.4) | ||||
| Emergency cholecystectomy | 1 | ||||||
| Yes | 73 | 63 (86.3) | 10 (13.7) | ||||
| No | 62 | 53 (85.5) | 9 (14.5) | ||||
| Type of cholecystectomy | 0.044 | ||||||
| Open | 11 | 10 (90.9) | 1 (9.1) | ||||
| Laparoscopic converted to open | 28 | 20 (71.4) | 8 (28.6) | ||||
| Laparoscopic | 97 | 87 (89.7) | 10 (10.3) | ||||
| Disruption of gallbladder wall | 0.2 | ||||||
| Yes | 47 | 37 (78.7) | 10 (21.3) | ||||
| No | 73 | 64 (87.7) | 9 (12.3) | ||||
| T-stage | 0.025 | ||||||
| 1b | 14 | 14 (100) | 0 | ||||
| 2 | 68 | 63 (92.6) | 5 (7.4) | ||||
| 3 | 54 | 40 (74.1) | 14 (25.9) | ||||
| Inflammation | 0.18 | ||||||
| Yes | 95 | 79 (83.2) | 16 (16.8) | ||||
| No | 40 | 37 (92.5) | 3 (7.5) | ||||
| Gallstones | 1 | ||||||
| Yes | 125 | 107 (85.6) | 18 (14.4) | ||||
| No | 11 | 10 (90.9) | 1 (9.1) | ||||
| Gallbladder polyp | 0.2 | ||||||
| Yes | 12 | 12 (100) | 0 | ||||
| No | 124 | 105 (84.7) | 19 (15.3) | ||||
| Tumour type | 0.2 | ||||||
| Adenocarcinoma | 124 | 108 (87.1) | 16 (12.9) | ||||
| Adenosquamous | 8 | 7 (87.5) | 1 (12.5) | ||||
| Squamous | 2 | 1 (50.0) | 1 (50.0) | ||||
| Neuroendocrine | 2 | 1 (50.0) | 1 (50.0) | ||||
| Grade of differentiation | 0.015 | 0.006 | |||||
| Good | 15 | 15 (100) | 0 | Ref. | |||
| Moderate | 67 | 62 (92.5) | 5 (7.5) | 1.77 | 0.22–NA | ||
| Poor | 52 | 38 (73.1) | 14 (26.9) | 7.64 | 1.10–NA | ||
| Lymph node status | 0.2 | ||||||
| Negative | 15 | 13 (86.7) | 2 (13.3) | ||||
| Positive | 19 | 14 (73.7) | 5 (26.3) | ||||
| Unknown | 102 | 90 (88.2) | 12 (11.8) | ||||
| Lymphovascular invasion | 0.4 | ||||||
| Present | 53 | 42 (79.2) | 11 (20.8) | ||||
| Absent | 52 | 45 (86.5) | 7 (13.5) | ||||
| Perineural invasion | 0.058 | ||||||
| Present | 46 | 35 (76.1) | 11 (23.9) | ||||
| Absent | 54 | 49 (90.7) | 5 (9.3) | ||||
| Positive cholecystectomy margin | 0.002 | 0.004 | |||||
| Yes | 61 | 46 (75.4) | 15 (24.6) | 5.44 | 1.51–24.37 | ||
| No | 74 | 70 (94.6) | 4 (5.4) | ||||
| Site of positive margin | <0.0001 | ||||||
| Gallbladder bed | 32 | 26 (81.3) | 6 (18.8) | ||||
| Cystic duct | 25 | 19 (76.0) | 4 (16.0) | ||||
| Gallbladder bed + cystic duct | 4 | 1 (25.0) | 3 (75.0) | ||||
| Negative margin | 74 | 70 (94.6) | 4 (5.4) | ||||
| Studies suggesting residual disease | 0.02 | ||||||
| Mean ± standard deviation | 0.38 ± 0.6 | 0.33 ± 0.6 | 0.68 ± 0.7 | ||||
| Median (range) | 0 (0–2) | 1 (1–3) | 1 (0–2) | ||||
DD, disseminated or unresectable disease; US, ultrasound; GB, gallbladder.