Radical surgery for de novo gallbladder carcinoma—Single-center analysis of prognostic factors and survival outcomes from an endemic region
Sameer Gupta MS, MCh
Department of Surgical Oncology, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India
Search for more papers by this authorCorresponding Author
Puneet Prakash MS, MCh
Department of Surgical Oncology, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India
Correspondence Puneet Prakash, Department of Surgical Oncology, King George's Medical University (KGMU), Shah Mina Rd, Lucknow, Uttar Pradesh 226003, India.
Email: [email protected]
Search for more papers by this authorVijay Kumar MS, MCh
Department of Surgical Oncology, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India
Search for more papers by this authorArun Chaturvedi MS, MAMS
Department of Surgical Oncology, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India
Search for more papers by this authorSanjeev Misra MS, MCh, FRCS, FICS, FACS, FAMS, FNASc
Department of Surgical Oncology, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India
AIIMS, Jodhpur, Rajasthan, India
Search for more papers by this authorNaseem Akhtar MS, MCh
Department of Surgical Oncology, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India
Search for more papers by this authorShiv Rajan MS, MCh
Department of Surgical Oncology, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India
Search for more papers by this authorPreeti Agarwal MD
Department of Pathology, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India
Search for more papers by this authorLynette M. Smith PhD
Department of Biostatistics, University of Nebraska Medical Centre, Omaha, Nebraska, USA
Search for more papers by this authorChandrakanth Are MD, MBA, FSSO, FRCS, FACS
Department of Surgery, Department of Surgical Oncology, University of Nebraska Medical Centre, Omaha, Nebraska, USA
Search for more papers by this authorSameer Gupta MS, MCh
Department of Surgical Oncology, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India
Search for more papers by this authorCorresponding Author
Puneet Prakash MS, MCh
Department of Surgical Oncology, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India
Correspondence Puneet Prakash, Department of Surgical Oncology, King George's Medical University (KGMU), Shah Mina Rd, Lucknow, Uttar Pradesh 226003, India.
Email: [email protected]
Search for more papers by this authorVijay Kumar MS, MCh
Department of Surgical Oncology, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India
Search for more papers by this authorArun Chaturvedi MS, MAMS
Department of Surgical Oncology, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India
Search for more papers by this authorSanjeev Misra MS, MCh, FRCS, FICS, FACS, FAMS, FNASc
Department of Surgical Oncology, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India
AIIMS, Jodhpur, Rajasthan, India
Search for more papers by this authorNaseem Akhtar MS, MCh
Department of Surgical Oncology, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India
Search for more papers by this authorShiv Rajan MS, MCh
Department of Surgical Oncology, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India
Search for more papers by this authorPreeti Agarwal MD
Department of Pathology, King George's Medical University (KGMU), Lucknow, Uttar Pradesh, India
Search for more papers by this authorLynette M. Smith PhD
Department of Biostatistics, University of Nebraska Medical Centre, Omaha, Nebraska, USA
Search for more papers by this authorChandrakanth Are MD, MBA, FSSO, FRCS, FACS
Department of Surgery, Department of Surgical Oncology, University of Nebraska Medical Centre, Omaha, Nebraska, USA
Search for more papers by this authorAbstract
Background and Objective
Gallbladder cancer (GBC) is an aggressive malignancy where curative resection is possible in few and survival is poor. There are limited data on outcomes in patients with de novo GBC from endemic regions undergoing surgery for curative intent. We report survival outcomes in this group of patients from a region with high incidence of disease.
Methods
We reviewed the records of all GBC patients (2014–2018) and included those who underwent radical cholecystectomy (RC) for de novo GBC. Univariable and multivariable analyses were performed to identify factors influencing recurrence and survival.
Results
A total of 649 patients with GBC were evaluated for surgery and curative intent surgery was attempted in 246 (38%) patients. Of these 246 patients, RC was performed in 115 patients, with histologically confirmed de novo GBC. Locally advanced disease (≥stage IIIB) was present in 52 (45.2%) patients. Median time to recurrence and overall survival (OS) were 31 and 36 months, respectively. Lymph node positivity (p = 0.005) and grade significantly influenced OS on multivariable analysis.
Conclusion
Satisfactory survival outcomes are possible after RC for de novo GBC. Extended resections performed in high volume centers combined with appropriate adjuvant treatment can offer significant survival benefits, with acceptable morbidity and mortality rates.
CONFLICT OF INTERESTS
The authors declare that there are no conflict of interests.
Open Research
DATA AVAILABILITY STATEMENT
Data are available from the corresponding author upon reasonable request.
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