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Towards standardization of management of gallbladder carcinoma with obstructive jaundice: Analysis of 113 cases over 10 years at a single institution
Author(s) -
Goel Mahesh,
Gupta Amit M.,
Patkar Shraddha,
Parray Amir M.,
Shetty Nitin,
Ramaswamy Anant,
Patil Prachi,
Chopra Supriya,
Ostwal Vikas,
Kulkarni Suyash,
Engineer Reena,
Mehta Shaesta
Publication year - 2021
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26564
Subject(s) - medicine , jaundice , gallbladder , gallbladder cancer , retrospective cohort study , gastroenterology , cohort , bile duct , obstructive jaundice , surgery , carcinoma
Abstract Background Presence of jaundice in gallbladder carcinoma (GBC) is considered a sign of inoperability with no defined treatment pathways. Methods Retrospective analysis of all surgically treated GBC patients from January 2010 to December 2019 was performed for evaluating etiology of obstructive jaundice, resectability, postoperative morbidity, mortality, disease‐free survival (DFS) and overall survival (OS). Results Out of 954 patients, 521 patients (54.61%) were locally advanced gallbladder carcinoma (LAGBC: Stage III and IV) and 113 patients (11.84%) had jaundice at presentation. Thirty‐four (30%) patients had benign cause of obstructive jaundice. Median OS of the whole cohort (n=113) was 22 months (16.5–27.49 months) with resectability rate of 62% (70/113). Median OS of curative resection group (n=70) was 32 months and DFS was 25 months. Treatment completion was achieved in 30% (n= 21/70) patients with median OS of 46 months and median DFS of 27 months. Isolated bile duct infiltration subgroup fared the best with median OS of 74 months with a 5‐year survival of 66.7%. Conclusion Surgical resection as a part of multimodality treatment improves survival in carefully selected locally advanced gallbladder cancer patients with jaundice. Early introduction of systemic therapy is the key in the management of this disease with aggressive tumor biology.