Unsuspected gallbladder cancer: a clinical retrospective study.

BACKGROUND

The morbidity of unsuspected gallbladder carcinoma (UGC) has increased. This study was aimed to explore the factors which may influence the therapeutic strategies and prognosis of UCG. Additionally, long-term prognosis of laparoscopic and open surgeries of UGC was comparatively investigated.

METHODS

Thirty-eight cases of UGC were enrolled in this study. Statistical analysis of survival was performed using the Kaplan-Meier test and the results were examined using the log-rank test.

RESULTS

The morbidity of UGC was 0.43 %. The cancer stagings were: pT1a (one), pT1b (11), pT2 (14), pT3 (10), pT3N1 (one), and pT4 (one). The median lifespan of the entire cohort was 20.0 ± 6.5 months, one-year survival rate was 44 %, and five-year survival rate was 11 %. One-year recurrence- free survival rate was 44 % and three-year recurrence- free survival rate was 0 %. Twenty-eight patients sustained cancer recurrence and three patients sustained port-site cancer recurrence. The cancer staging (P < 0.01) and radical resection (P < 0.01) were independent factors for both overall and recurrence-free survival. Radical resection improved the prognosis of the patients with pT2 stage UGC (P < 0.05), but no significant impact on the prognosis of the patients with pT1b (P = 0.362) or pT3 stage (P = 0.221) UGC. Survival rates were not significantly affected by the first operation no matter it was laparoscopic surgery or open surgery (P = 0.12).

CONCLUSION

Radical resection surgery is recommended in pT2 stage UGC. There is no difference for the long-term prognosis between laparoscopic surgery (cholecystectomy) and open surgery of UCG.