OBJECTIVES: To determine the prevalence of incidentally found cases of gallbladder cancer, the incidence of residual disease at reexploration, and the changes in the mode of presentation, treatment, and survival of patients with gallbladder cancer during a period of more than 4 decades. DESIGN: Retrospective case series. SETTING: University-affiliated tertiary care center. PATIENTS: Between January 1, 1962, and March 1, 2008, 402 patients with gallbladder cancer were identified and their clinicopathologic data were analyzed. INTERVENTIONS: Surgical treatment, radiotherapy, and chemotherapy. MAIN OUTCOME MEASURES: Incidentally discovered gallbladder cancer, incidence of residual disease, and differences in presentation, treatment, and survival. RESULTS: Surgical exploration was performed in 260 patients (64.7%), of whom 151 (58.1%) underwent resection. The median age of the patients was 72 years, and 72.3% were female. Between January 1, 1994, and March 1, 2008, 6881 laparoscopic cholecystectomies were performed, and there were 17 incidentally discovered cases of gallbladder cancer (0.25%). Residual disease on reexploration was identified in 0 of 2 patients with T1 tumor, 3 of 13 patients with T2 tumor, and 8 of 10 patients with T3 tumor (P = .01). Patients with stage IV disease (34 [13.1%] diagnosed from 1962-1979; 34 [13.1%] diagnosed from 1980-1997; and 22 [8.5%] diagnosed from 1998-2008) had a median survival of 4 months (range, 0-37 months). Concomitant liver resections increased in the third study period (11.1%, 10.1%, and 54.3%; P < .001), with an increase in negative margins (33.3%, 42.0%, and 63.0%; P = .01). Cox regression analysis identified T stage and surgical margin status as significant prognostic factors. CONCLUSIONS: Gallbladder cancer is incidentally found during 0.25% of laparoscopic cholecystectomies. As T stage increases, the likelihood of residual disease on reexploration increases. Although many patients with gallbladder cancer present with incurable disease and have very poor survival, the overall prognosis is improving, likely because of more extensive operations.
OBJECTIVES: To determine the prevalence of incidentally found cases of gallbladder cancer, the incidence of residual disease at reexploration, and the changes in the mode of presentation, treatment, and survival of patients with gallbladder cancer during a period of more than 4 decades. DESIGN: Retrospective case series. SETTING: University-affiliated tertiary care center. PATIENTS: Between January 1, 1962, and March 1, 2008, 402 patients with gallbladder cancer were identified and their clinicopathologic data were analyzed. INTERVENTIONS: Surgical treatment, radiotherapy, and chemotherapy. MAIN OUTCOME MEASURES: Incidentally discovered gallbladder cancer, incidence of residual disease, and differences in presentation, treatment, and survival. RESULTS: Surgical exploration was performed in 260 patients (64.7%), of whom 151 (58.1%) underwent resection. The median age of the patients was 72 years, and 72.3% were female. Between January 1, 1994, and March 1, 2008, 6881 laparoscopic cholecystectomies were performed, and there were 17 incidentally discovered cases of gallbladder cancer (0.25%). Residual disease on reexploration was identified in 0 of 2 patients with T1 tumor, 3 of 13 patients with T2 tumor, and 8 of 10 patients with T3 tumor (P = .01). Patients with stage IV disease (34 [13.1%] diagnosed from 1962-1979; 34 [13.1%] diagnosed from 1980-1997; and 22 [8.5%] diagnosed from 1998-2008) had a median survival of 4 months (range, 0-37 months). Concomitant liver resections increased in the third study period (11.1%, 10.1%, and 54.3%; P < .001), with an increase in negative margins (33.3%, 42.0%, and 63.0%; P = .01). Cox regression analysis identified T stage and surgical margin status as significant prognostic factors. CONCLUSIONS:Gallbladder cancer is incidentally found during 0.25% of laparoscopic cholecystectomies. As T stage increases, the likelihood of residual disease on reexploration increases. Although many patients with gallbladder cancer present with incurable disease and have very poor survival, the overall prognosis is improving, likely because of more extensive operations.
Authors: Juan C Roa; Oscar Tapia; Carlos Manterola; Miguel Villaseca; Pablo Guzman; Juan Carlos Araya; Pelin Bagci; Burcu Saka; Volkan Adsay Journal: Virchows Arch Date: 2013-09-11 Impact factor: 4.064
Authors: Raphael L C Araujo; Marco Aurélio de Sanctis; Tomás R V Coelho; Fernando E C Felippe; Diego Burgardt; Durval R Wohnrath Journal: J Gastrointest Cancer Date: 2020-03
Authors: Mia S DeSimone; Michael Goodman; Burcin Pehlivanoglu; Bahar Memis; Serdar Balci; Juan Carlos Roa; Kee-Taek Jang; Jin-Young Jang; Seung-Mo Hong; Kyoungbun Lee; Haeryoung Kim; Hye-Jeong Choi; Takashi Muraki; Juan Carlos Araya; Enrique Bellolio; Juan M Sarmiento; Shishir K Maithel; Hector F Losada; Olca Basturk; Michelle D Reid; Jill Koshiol; Volkan Adsay Journal: Virchows Arch Date: 2021-01-07 Impact factor: 4.064
Authors: Andrea P Moy; Mohammad Shahid; Cristina R Ferrone; Darrell R Borger; Andrew X Zhu; David Ting; Vikram Deshpande Journal: Virchows Arch Date: 2015-02-14 Impact factor: 4.064
Authors: John M Creasy; Debra A Goldman; Mithat Gonen; Vikas Dudeja; Eileen M O'Reilly; Ghassan K Abou-Alfa; Andrea Cercek; James J Harding; Vinod P Balachandran; Jeffrey A Drebin; Peter J Allen; T P Kingham; Michael I D'Angelica; William R Jarnagin Journal: HPB (Oxford) Date: 2019-04-23 Impact factor: 3.647