Timing of Curative Resection in Incidental Carcinoma of the Gall Bladder: Does It Really Matter?
Suchita Chowdhury1, Abhishek Aggarwal1, Anupam Lahiri1
1Department of GI and HPB Oncosurgery, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India.
Purpose:
There is conflicting data in the literature regarding the optimal timing of curative surgery in incidental gallbladder cancer (IGBC). The aim of this study was to assess the impact of the timing of surgery in IGBC on disease-free (DFS) and overall survival (OS).
Methods:
Data of all patients of IGBC who underwent completion radical cholecystectomy from January 2012 to December 2022 was retrieved from a prospectively maintained electronic database. Patients were divided into two groups based on the interval between the cholecystectomy and completion radical cholecystectomy: early (≤ 4 weeks) and late (> 4 weeks). The groups were compared using appropriate statistical methods.
Results:
There were 44 and 47 patients in early and late groups respectively. Both groups were comparable in all demographic, preoperative, operative, postoperative, and histopathological characteristics. At a median follow-up of 36 months, median DFS and OS were not reached. There was no difference in early and late groups in mean DFS (41 vs. 43 months) and OS (47 vs. 46 months).
Conclusion:
Timing of curative surgery did not have any impact on intraoperative blood loss, duration of surgery, hospital stay, complication rates, and lymph node retrieval. Early surgery was associated with better adjuvant therapy completion rates (95% vs. 77%, p = 0.04). Mean DFS and OS were similar in both groups. So timing of surgery in IGBC did not have any impact on short term and long term outcomes.
