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Treatment Outcomes of Incidental Gallbladder Cancer – Results from a High-Volume Tertiary Care Centre in North India

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Abstract

Gallbladder cancer (GBC) is a lethal disease. Incidentally detected gallbladder cancer (IGBC) presents a unique opportunity for early management and better outcomes. We present the institutional experience of a high-volume tertiary care center in northern India. Retrospective analysis of a prospectively maintained database was performed and data of all IGBC patients between January 2014 to December 2021 was analyzed. There were 125 patients of IGBC among the 750 patients of GBC seen during the study period. Of these 125 patients, 72 (57.6%) patients were not eligible for surgery. Successful completion radical cholecystectomy (CRC) was possible in 37 (69.8%) of the 53 patients who underwent surgery. On univariate analysis, thickness of gallbladder wall 10 mm or more (p < 0.001, OR 19.0, 95% CI 4.58–78.76), pathological stage (p < 0.001, OR 5.8, 95% CI 2.45–14.98) and median delay of 16 weeks or more (p < 0.001, OR 17.0, 95% CI = 4.08–70.76), were associated with inoperability. However, on multivariate analysis only gallbladder wall thickness of 10 mm or more (p < 0.001, AOR 17.9, 95% CI 3.24–98.78) and median delay of 16 weeks or more (p < 0.001, AOR 32.33, 95% CI 6.05–172.66) remained significant. Median time to recurrence (TTR) and overall survival (OS) was not reached after a median follow up of 30 months in patients undergoing successful CRC. Successful outcomes of IGBC are dependent on several factors. Diligent workup of suspicious thickening before simple cholecystectomy for gallstone disease and timely referral of IGBC to tertiary care are the keystones for good outcomes.

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Authors and Affiliations

  1. Department of Surgical Oncology, King George’s Medical University, Lucknow, 226003, India

    Arun Chaturvedi, Sameer Gupta, Puneet Prakash, Vijay Kumar, Naseem Akhtar & Shiv Rajan

  2. Atal Bihari Vajpayee Medical University, Lucknow, 226010, India

    Sanjeev Misra

  3. Sahara Hospital, Lucknow, India

    Shashank Chaudhary

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  1. Arun Chaturvedi
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  2. Sanjeev Misra
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  4. Sameer Gupta
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Contributions

Conceptualization: [Arun Chaturvedi, Sanjeev Misra, Sameer Gupta]; Methodology [Arun Chaturvedi, Vijay Kumar, Puneet Prakash], Formal Analysis [Puneet Prakash, Shashank Chaudhary], Writing, review and editing [Arun Chaturvedi, Puneet Prakash, Naseem Akhtar, Shiv Rajan], Supervision [Arun Chaturvedi, Sanjeev Misra].

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Correspondence to Puneet Prakash.

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Chaturvedi, A., Misra, S., Chaudhary, S. et al. Treatment Outcomes of Incidental Gallbladder Cancer – Results from a High-Volume Tertiary Care Centre in North India. Indian J Surg Oncol (2024). https://doi.org/10.1007/s13193-024-01937-7

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