Incidental gallbladder cancer diagnosed on cholecystectomy specimens: a study of 30 cases

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Published Feb 1, 2017
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Vol. 94 No. 6 (2016): Issue Jun 2016

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Sana Ben Slama
Rym Ennaifer
Service de Gastro-entérologie Hôpital H. Thameur Tunis
Dhouha Bacha
Rached Bayar
Saadia Bouraoui
Lassaad Gharbi
Ahlem Lahmar

Abstract

Abstract
Background: The gallbladder cancer is a rare cancer with poor prognosis. The association with gallstone disease is the main risk factor of this cancer.
Aim: Describe the demographics, clinic-pathologic and therapeutic management of incidentally gallbladder cancer diagnosed on cholecystectomy specimens.
Methods: retrospective study including 30 cases of gallbladder cancer incidentally detected on cholecystectomy specimens.
Results: The incidence of gallbladder cancer incidentally discovered was 0.83%. The sex ratio M/F was 0.5 and the average age was 68 years. The main risk factor was cholelithiasis (38%). Adenocarcinoma was the most frequent histological type found in 86.6% of cases and it was biliary-type in 56.6% of cases. 76,7% of the tumors were classified in early stages (stages 0, I and II) and 23,3% were in advanced stages (III and IV). A simple cholecystectomy was curative in 66.7% of cases. Overall survival rate was 56.7% at one year. The best survival rate was for the early stages: 100% stages 0-I and 45.4% stage II. Conclusions: The gallbladder cancer has poor prognosis because of its late diagnosis. Thorough sampling and careful attention on histological examination of all parts of cholecystectomy specimens allows detection of early cancer with better prognosis.

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References

  1. Ferrarese AG, Solej M, Enrico S et al. Diagnosis of incidental gallbladder cancer after laparoscoplc cholecystectomy: Our experience. BMC Surg. 2013;13:20.
  2. Pavlidis TE, Pavlidis ET, Symeonidis NG, Psarras K, Sakantamis AK. Current curative surgical management of gallbladder cancer: a brief review. J Curr Surg. 2012;2:81-3.
  3. Hamdani NH, Qadri SK, Aggarwalla R et al. Clinicopthological study of Gallbladder Carcinoma with special reference to Gallstones: Our 8-year experience from Eastern India. Asian Pac J Cancer Prev. 2012;13:5613-7.
  4. Sachidananda S, Krishnan A, Janani K et al. Characteristics of Gallbladder Cancer in South India. Indian J Surg Oncol. 2012;3:228-30.
  5. Le MD, Henson D, Young H, Albores-Saavedra J. Is gallbladder cancer decreasing in view of increasing laparoscopic cholecystectomy? Ann Hepatol. 2011;10:306-14.
  6. Zouaoui W, Mormeche Y, Khlifi S et al. Aspect en imagerie du cancer de la vésicule biliaire: à propos de 40 cas. Feuillets de radiologie, 1ère édition. Edition Elsevier 2009;49:15-23.
  7. Goetze TO, Paolucci V. Prognosis of incidental gallbladder carcinoma is not influenced by the primary access technique: analysis of 837 incidental gallbladder carcinomas in the German Registry. Surg Endosc. 2013;27:2821- 8.
  8. Bosman FT, Carneiro F, Hruban RH, Theise ND. WHO classification of tumours of the digestive system. 4th Edition. Lyon: International Agency for Research on Cancer (IARC);2010.
  9. Sobin LH, Gospodarowicz MK, Wittekind C. Digestive system: gallbladder. TNM classification of malignant tumours. 7th edition. Washington DC: Wiley- Blackwell publication and UICC;2009:118-121.
  10. Gall FP, Köckerling F, Scheele J, Schneider C, Hohenberger W. Radical operations for carcinoma of the gallbladder: present status in Germany. World J Surg. 1991;15:328-36.
  11. Rathanaswamy S, Misra S, Kumar V et al. Incidentally detected gallbladder cancer-the controversies and algorithmic approach to management. Indian J Surg. 2012;74:248-54.
  12. Toyonaqa T, Chijiiwa K, Nakano K et al. Completion radical surgery after cholecystectomy for accidentally undiagnosed gallbladder carcinoma. World J Surg. 2003;27:266-71.
  13. Alvi AR, Siddiqui NA, Zafar H. Risk factors of gallbladder cancer in Karachi- a case control study. World J Surg Oncol. 2011;9:164.
  14. Kiran RP, Pokala N, Dudrick SJ. Incidence pattern and survival for gallbladder cancer over three decades - an analysis of 10301 patients. Ann Surg Oncol. 2007;14:827-32. 15- Gupta SK, Shukla VK. Gallbladder cancer etiopathology and treatment. Hlth Adm. 2011;17:134-42.
  15. Gupta SK, Shukla VK. Gallbladder cancer etiopathology and treatment. Hlth Adm. 2011;17:134-42.
  16. Kalita D, Pant L, Singh S et al. Impact of routine of histopathological examination of gallbladder specimens on early detection of malignancy- a study of 4,115 cholecystectomy specimens. Asian Pac J Cancer Prev. 2013;14:3315-8.
  17. Kianmanesh R, Scaringi S, Castel B, Flamant Y, Msika S. Precancerous lesions of the gallbladder. J Chir (Paris). 2007;144:278-86.
  18. Puia IC, Puia A. Porcelain gallbladder and cancer - an association to be revised. J Gastrointestin Liver Dis. 2013;22:358-9.
  19. Kianmanesh R, Régimbeau JM, Belghiti J. Anomalies de la jonction biliopancréatique et dilatations kystiques congénitales des voies biliaires de l'adulte. J Chir. 2001;138:196-204.
  20. Hu L, Wang B, Liu X, Lv Y. Unsuspected gallbladder cancer: A clinical retrospective study. Arch Iran Med. 2013;16:631-5.
  21. Zhu AX, Hong TS, Hezel AF, Kooby DA. Current management of gallbladder carcinoma. Oncologist. 2010;15:168-81.
  22. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A. AJCC Cancer Staging Manual 7th ed. New York: Springer;2009.
  23. Shaffer EA. Gallbladder cancer: the basics. Gastroenterol Hepatology. 2008;4:737-41.
  24. Cubertafond P, Mathonnet M, Gainant A, Launois B. Radical surgery for gallbladder cancer. Results of the French Surgical Association Survey. Hepatogastroenterology. 1999;46:1567-71.
  25. Yi X, Long X, Zai H, Xiao D, Li W, Li Y. Unsuspected gallbladder carcinoma discovered during or after cholecystectomy: focus on appropriate radical re- resection according to the T-stage. Clin Transl Oncol. 2013;15:652-8.
  26. Albores-Saavedra J, Batich K, Hossain S, Henson DE, Schwartz AM. Carcinoid tumors and small-cell carcinomas of the gallbladder and extra hepatic bile ducts: a comparative study based on 221 cases from the Surveillance, Epidemiology, and End Results Program. Ann Diagn Pathol. 2009;13:378-83.