Prognosis of incidental gallbladder carcinoma is not influenced by the primary access technique: analysis of 837 incidental gallbladder carcinomas in the German Registry

Abstract

The GR data, which relate to a large homogenous patient cohort, showed that when other potential influencing factors, e.g., IRR were eliminated, the primary access technique had no effect on prognosis. Stage-adjusted therapy should always be performed irrespective of the primary access technique.

Radical Surgery for Incidental Gallbladder Carcinoma. Which Subset of Patients is Really Suitable for?

“…In addition, while patients with in-situ and intramucosal carcinomas are all alive after a mean follow-up of 69 months, T2 and T3 lesions showed, overall, an unsatisfactory prognosis with a median of 19 and 5 months for the two groups, respectively; these findings coincide with those reported by many authors [7,8,[12][13][14][15][16][17][18][19][20][21][22][23][24][25].…”

“…Furthermore, the frequent occurrence of the gallbladder carcinoma in the seventh and eighth life decade [3] (8 patients in our group are more than 75 years old) could make problematic the indication to a demanding surgical procedure comprising an extended liver resection and nodal dissection, in which are described postoperative complication rates up to 30-40% [8,9], even in the more recent literature [13][14][15][16][17][18][19][20][21][22][23][24][25].…”

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2nd English edition

“…On the other hand, in gallbladder carcinoma invading the subserosal layer, high rates of vascular and perineural invasion and lymph node involvement are observed [180][181][182][183][184][185]. In fact, there are many reports that have showed an additional resection improved the prognosis of patients with incidental gallbladder carcinoma [167,168,[186][187][188][189]. Therefore, an additional resection including hepatectomy and lymph node dissection should be considered for patients with incidental gallbladder carcinoma invading subserosal layer or more.…”

Benefit of extended radical surgery for incidental gallbladder carcinoma

“…In the current era of laparoscopic surgery, the number of IGCs found during laparoscopic cholecystectomy is increasing. Port site recurrence and peritoneal dissemination caused by intra-operative perforation of the gallbladder are inevitably associated with IGC; however, Goetze et al reported that the primary access technique had no effect on prognosis [29], and Fuks et al reported that port site resection was not associated with the improved survival of patients with IGC [30]. Because this study included only six patients who underwent laparoscopic cholecystectomy, we cannot conclude whether port site resection should be performed routinely as part of ICG treatment.…”