Impact of Therapeutic Interventions on Survival of Elderly Patients with Gallbladder Carcinoma: A 10-year Single Center Experience

Background: Primary gallbladder carcinoma (GBC) is associated with poor prognosis. This study aimed to clarify the age-specific clinical characteristics of primary GBC among elderly patients. Methods: We retrospectively reviewed the medical records of patients with GBC treated in Mackay Memorial Hospital, Taipei, Taiwan over a period of 10 years, from 2003 to 2012. Patients aged 65 years or older at the time of diagnosis of primary GBC were defined as the elderly group. According to the Kaplan-Meier method, survival curves were compared between patients receiving surgical treatment or not. Results: In total, 64 patients with primary GBC were reviewed. Forty-eight patients (75%) were included in the elderly group. Mean age of the patients at the time of diagnosis was 77.8 +/- 7.1 years. Compared with young group, the serum level of carcinoembryonic antigen was significantly higher (p = 0.025) and hemoglobin was significantly lower (p = 0.025) in the elderly group. The percentages of elderly patients in the tumor-node-metastasis (TNM) Stages 0-III and IV were 50.0%, and 50.0%, respectively. Twenty-six patients received surgical resection. The cumulative survival curves of the surgical intervention and nonsurgical intervention groups differed significantly for elderly patients in the TNM Stages 0-III (p = 0.002) and Stage IV (p = 0.041). Conclusion: Most elderly patients at the time of diagnosis of GBC were in TNM Stage IV. Surgery was the predominant treatment at our hospital. Surgical interventions might be associated with better survival for elderly patients with GBC. Copyright (C) 2015, Taiwan Society of Geriatric Emergency & Critical Care Medicine. Published by Elsevier Taiwan LLC. All rights reserved.