Incidental Gallbladder Cancer: Analysis of Surgical Findings and Survival

Background and Objectives: Incidental gallbladder cancer (IGBCA) has risen worldwide and its prognosis depends on complete radical cholecystectomy (CRC) This study evaluated surgical findings during re-operation and survival of patients with IGBCA Methods: Demographics, surgical treatment, staging, and survival data for all IGBCA patients who underwent surgery at Instituto Oncologico Fundacion Arturo Lopez Perez (FALP) between 2000 and 2008 were analyzed Differences between groups were analyzed by Student's t-test. Mann Whitney. chi-square, or Fisher log-rank tests Results: Forty-nine patients were studied (38 women/11 men, median age = 58 years) Pathology reports from cholecystectomy showed that 32 patients had a T2 tumor and 12 had positive resection margin Thirty-six patients underwent surgical re-exploration and 20 underwent CRC, 10 with (+) residual disease and 10 with (-) For patients with at least T1b tumor, median survival was 28 months and 5-year disease-specific Survival (DSS) was 29% The 3-year DSS was 64% for CRC (-). 30% for CRC (-). and 8% for non-resected cases (P < 0 007) The 3-year DSS was better for patients with stage Ib than those with stages II and IV (P < 0 007) Conclusions: Patients with IGBCA have a high chance of intra-abdominal metastases or local residual disease In CRC patients, ultra-abdominal metastases were associated with a worse prognosis Surg Oncol 2010,102 620-625 (C) 2010 Wiley-Liss, Inc