Shraddha Patkar1, Vikas Ostwal2, Anant Ramaswamy2, Reena Engineer3, Supriya Chopra3, Nitin Shetty4, Rohit Dusane5, Shailesh V Shrikhande1, Mahesh Goel1. 1. GI and HPB Service, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India. 2. Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India. 3. Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India. 4. Department of Interventional Radiology, Tata Memorial Hospital, Mumbai, India. 5. Department of Biostatistics, Tata Memorial Hospital, Mumbai, India.
Abstract
BACKGROUND AND OBJECTIVES: Gall bladder cancer (GBC) is a disease with high incidence in India. We analyzed the outcomes of patients with suspected GBC who underwent surgical exploration. METHODS: Analysis of a prospectively maintained database of patients undergoing surgical exploration for clinic-radiologically suspected GBC from January 2010 to August 2015. Outcomes as well as factors influencing survival were analyzed. RESULTS: Five hundred and ten patients underwent surgery for suspected GBC. Of these 400 had histologically proven malignancy. Eighty patients were deemed inoperable. Radical cholecystectomy was performed in 153 patients, revision surgery for incidental GBC in 160 and port site excision in seven patients. A total of 112 received peri-operative chemotherapy or chemoradiation. Majority were stage III (36%, n = 144) and stage II (31.8% n = 127). At a median follow up of 28.4 months, the median overall survival (OS) was not yet reached. Median disease free survival (DFS) was 33.4 months. Lymph node involvement, stage of the disease and resection status were the main factors influencing outcomes (P = 0.0001). CONCLUSION: Surgery alone is curative only for early GBC (Stage I). Combination of surgery and peri-operative systemic therapy results in favorable outcomes even in stage II/III disease. Potentially, multimodality treatment may add meaningful survival for this disease with inherently aggressive tumor biology.
BACKGROUND AND OBJECTIVES:Gall bladder cancer (GBC) is a disease with high incidence in India. We analyzed the outcomes of patients with suspected GBC who underwent surgical exploration. METHODS: Analysis of a prospectively maintained database of patients undergoing surgical exploration for clinic-radiologically suspected GBC from January 2010 to August 2015. Outcomes as well as factors influencing survival were analyzed. RESULTS: Five hundred and ten patients underwent surgery for suspected GBC. Of these 400 had histologically proven malignancy. Eighty patients were deemed inoperable. Radical cholecystectomy was performed in 153 patients, revision surgery for incidental GBC in 160 and port site excision in seven patients. A total of 112 received peri-operative chemotherapy or chemoradiation. Majority were stage III (36%, n = 144) and stage II (31.8% n = 127). At a median follow up of 28.4 months, the median overall survival (OS) was not yet reached. Median disease free survival (DFS) was 33.4 months. Lymph node involvement, stage of the disease and resection status were the main factors influencing outcomes (P = 0.0001). CONCLUSION: Surgery alone is curative only for early GBC (Stage I). Combination of surgery and peri-operative systemic therapy results in favorable outcomes even in stage II/III disease. Potentially, multimodality treatment may add meaningful survival for this disease with inherently aggressive tumor biology.
Authors: Mohammad Y Zaidi; Ghassan K Abou-Alfa; Cecilia G Ethun; Shailesh V Shrikhande; Mahesh Goel; Bruno Nervi; John Primrose; Juan W Valle; Shishir K Maithel Journal: Chin Clin Oncol Date: 2019-08-05
Authors: Prabhat G Bhargava; Amit Kumar; Vijai Simha; Minit Shah; Shraddha Patkar; Mahesh Goel; Vikas Ostwal; Anant Ramaswamy Journal: South Asian J Cancer Date: 2021-06-12