Carcinoma of the gall bladder: 8 year experience from a tertiary care centre, Punjab, India

Abstract

Background: Gall bladder carcinoma is the most common malignancy of biliary tract and one of the most aggressive gastrointestinal malignancies. The present study was conducted to know the clinical aspects, results and survival patterns after therapeutic interventions in patients of gall bladder cancer.Methods: The study is retrospective analysis of prospectively collected data of gall bladder cancer patients.Results: In 288 gall bladder cancer patient’s median age was 60 yrs. There were 219 females, 69 males (F:M=3.2:1). Median number of days from the onset of symptoms to presentation was 24.5 days. Majority of patients were stage IVB 162 (56.3%), least were stage I 3(1%). 192 (66.7%) patients received palliative treatment because of unresectable malignancy. 39 (13.5%) patients underwent noncurative surgical intervention. 57 (19.8%) patients underwent extended cholecystectomy. The median number of lymph nodes detected on histopathological examination was 4.5 (range 3-12). 21 patients (36.8%) had positive lymph nodes. Median follow up of all patients was 6 months (1-66 months). 27 (9.4%) patients survived till last date of follow up. Median survival time in groups undergoing extended cholecystectomy, noncurative surgery, chemotherapy alone was 12, 8 and 4 months respectively. The difference in median survival time between the groups was statistically significant, Log rank (Mantel-Cox) χ2=109.78, p=0.00.Conclusions: Carcinoma of the gall bladder predominately affects females. Majority of patients had delayed presentation, stage IVB. Extended cholecystectomy is the only effective treatment to achieve long term survival.

Histopathological changes in gall bladder mucosa in relation to the number, and size of gallstones, and analysis of the findings in the context of age distribution of the patients: A perspective

“…Long-standing cholelithiasis tends to cause constant damage to the GB mucosa over time, therefore older patients presenting with long history of cholelithiasis have a higher risk of GB carcinoma. Although the sample size may be small, the incidence of 5% cases of GB carcinoma among cholecystectomy cases in the current study, along with the recent study by Sharma and Singh [47] in Sri Guru Ramdass medical college, Amritsar, Punjab on GB cancer cases, highlights the magnitude of GB carcinoma disease affecting the residing population of the Punjab. Sharma and Singh [47] restrospectively analysed 288 cases of GB carcinoma during the period 2010-2018.…”

“…Although the sample size may be small, the incidence of 5% cases of GB carcinoma among cholecystectomy cases in the current study, along with the recent study by Sharma and Singh [47] in Sri Guru Ramdass medical college, Amritsar, Punjab on GB cancer cases, highlights the magnitude of GB carcinoma disease affecting the residing population of the Punjab. Sharma and Singh [47] restrospectively analysed 288 cases of GB carcinoma during the period 2010-2018. In this study, 66% cases had unresectable disease, and only 27 cases (9%) were able to survive to the last date of follow-up, hence portraying the high incidence and mortality caused by GB carcinoma.…”