Decreased survival of advanced colorectal cancer among patients with chronic cholecystitis: results from two clinical centers.

PURPOSE: Chronic cholecystitis is a common inflammatory disease of the gallbladder. It is related with various gastrointestinal tumors, although its pathogenesis is not clear. This study was designed to investigate the association between chronic cholecystitis and the survival of patients with advanced colorectal cancer (CRC).

METHODS

We conducted a population-based large-scale retrospective case-control study involving 1094 patients with advanced CRC, 286 patients with cholecystitis, and 808 without. The patients were admitted in two hospitals in China. Data were obtained from a patient survey by professional interviewers in addition to medical records. The statistical significance was estimated by Kaplan-Mayer analysis and Cox proportional hazard regression.

RESULTS

The chronic cholecystitis group had a shorter survival time than non- cholecystitis group (HR for Nanfang hospital patients 0.638, 95%CI 0.457-0.890, p=0.008; HR for Changzhou No.2 hospital patients 0.583, 95%CI 0.433-0.787, p<0.001). Surgery and chemotherapy could prolong the survival of patients CRC and reduce their mortality (surgery: HR for Nanfang hospital patients 1.638, 95%CI 1.087-2.469, p=0.018; HR for Changzhou No.2 hospital patients 2.137, 95%CI 1.399-3.265, p<0.001; chemotherapy: HR for Nanfang hospital patients 1.766, 95%CI 1.238-2.518, p=0.002; HR for Changzhou No.2 hospital patients 2.616, 95%CI 1.816-3.768. p<0.001). The higher the TNM staging, the shorter the survival time (TNM staging: HR for Nanfang hospital patients 3.912, 95%CI 3.201-4.781, p<0.001; HR for Changzhou No.2 hospital patients 3.907, 95%CI 3.05-5.005, p<0.001).

CONCLUSION

Cholecystitis was strongly associated with a poor long-term prognosis for patients with CRC. The results suggest that special attention to gallbladder inflammation might be needed during the treatment of CRC.