Incidental Gallbladder Cancer:Analysis Of Clinical Cases And Survival

Background and objectives:Gallbladder cancer is the most common biliary tract tumor worldwide. Its long term survival depends on the pathological stage and radical cholecystectomy. In recent years, with the popularity of laparoscopic gallbladder surgery, incidental gallbladder cancer (IGBCA) attracts more attention. This study evaluated the clinical characteristics and survival of patients with IGBCA.Methods:Characteristics of patients were analyzed including demographics, image, surgical treatment, pathological result and staging, clinical outcomes and survival data, survival curves were constructed with Kaplan-Meier method and compared using the log-rank test. Univariate analysis and multivariate analysis was performed with Cox regression. All statistical significance was defined at P<0.05.Results:Forty patients were studied (adenocarcinoma,33women/7men, median age=58years). Pathology reports from cholecystectomy showed that24patients had a T2tumor.11patients were diagnosed during cholecystectomy.21patients underwent radical surgery. For patients with at least T2tumor,1-year survival was69.4%,3-year survival was59.3%. For patients at stage Ⅱ, Ⅲ and Ⅳ,1-year survival was76.7%,49%and0%(P<0.05). The3-year survival for patients with T2tumor was71.1%(radical surgery+) and58.3%(radical surgery-)(P>0.05). The1-year survival for patients with T3tumor was50%(radical surgery+) and66.7%(radical surgery-)(P>0.05). Patients with lymph nodes involved had worse survival than those without lymph nodes involved (RR=0.160,95%CI0.027-0.946, P=0.043). Patients with metastases had worse survival than those without metastases(RR-0.124,95%CI0.020-0.749, P=0.023).Conclusions:The prognosis was significantly different among patients with stage II, Ⅲ, Ⅳ tumor. Higher stage indicated significant decreasing of1-year survival (P<0.05). Radical surgery made no significant difference of long term survival among patients with T1b, T2or T3tumor (P>0.05). Lymph nodes involved and metastases were two individual variables significantly decreasing patients’long term survival (P<0.05).