50P Ultrasound guided screening of gallbladder cancer in healthy volunteers: A prospective study from Northern India

Abstract

Screening leads to reduction in cancer specific mortality for breast, cervix and colon cancer. Advanced Gallbladder cancer (GBC) is the commonest malignancy in Northern India. Due to rarity in western world, it remains an orphan disease for research. It carries a dismal prognosis. We did a pilot work of screening of GBC in healthy volunteers. This is a prospective study conducted under Armed Forces Medical Research Project at Lucknow from Jun2011 till Oct2012 after ethical approval and among high risk individuals. High risk was defined as asymptomatic, age ≥50 years and residents in Uttar Pradesh or Bihar. Volunteers residing in this region for < 5 years excluded. Screening was done with Ultrasound. Volunteers with irregular or focal wall thickening were considered for radical cholecystectomy. Established cases were taken as control (C-GBC). Written informed consent was obtained for all participants. Demographics were studied and survival was compared with C-GBC patients. A total of 778 volunteers were screened for GBC. Four cases of GBC were detected (S-GBC). There were 3 females and 1 male among S-GBC patients (M: F:3: 1) and 87 males and 32 females (M: F:2.7 :1) in C-GBC cases. S-GBC patients had early stage of diagnosis (p= 0.001) as compared to C-GBC. All four cases underwent curative radical cholecystectomy compared to 18.8 % in C-GBC cases (p= 0.004). Median overall survival (mOS) not reached and 09 months in S-GBC and C-GBC (p= 0.0453), respectively. This pilot work established the proof of principle of screening for GBC, leading to early detection, ensures surgical resection and improved overall survival. This finding must be studied in future larger longitudinal studies.