Multimodality approach to gallbladder cancer: our experience at a tertiary care centre in Northern India

Abstract

Introduction: This study was done to assess the varied presentations in patients with gallbladder cancer (GBC), outcome following radical surgery and various modalities of palliation and to assess the survival of these patients. Methods: Retrospective analysis of the data of all GBC patients over 4 years. Outcome was assessed during follow-up visits and telephonic interviews. Patients with metastatic disease at presentation were not included. Results: 140 cases of GBC were analysed, with a 1:2 male to female ratio. Three most common modes of presentation were weight loss (55.7%), upper abdominal pain (45%) and jaundice (40%). Seven patients were diagnosed with incidental GBC following cholecystectomy. Most common radiological findings suggestive of GBC were focal or diffuse thickening of gallbladder wall (37 and 76 patients respectively), IHBRD (65), presence of regional/distant lymph nodes (34) and local infiltration (28). Majority of patients were admitted for palliation of jaundice for hilar blocks (52 patients). 46 patients were found to be resectable and underwent radical cholecystectomy. The average survival of patients at the end of 1 year was 45% following radical surgery and 10% following palliative modalities. Conclusions: Although GBC is an uncommon disease worldwide, it has a high incidence in Northern India, an endemic zone of gallstone disease. Patients usually have an advanced disease at presentation. However, patients with focal masses were found to benefit from surgery the most and had better survival. A greater awareness of the early symptoms of GBC and a screening programme is needed for early detection of GBC.