Academic Block GB Pant Hospital

Delhi, India

Academic Block GB Pant Hospital

Delhi, India
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Mishra P.K.,Academic Block GB Pant Hospital | Saluja S.S.,Academic Block GB Pant Hospital | Prithiviraj N.,Academic Block GB Pant Hospital | Varshney V.,Academic Block GB Pant Hospital | And 2 more authors.
American Journal of Surgery | Year: 2017

Background: Gallbladder cancer (GBC) is an aggressive malignancy. We analysed factors predicting resectability and survival of patients with GBC and the impact of surgical obstructive jaundice (SOJ). Methods: Four hundred and thirty-seven patients with suspected GBC were analysed (52 excluded: benign pathology n = 35, missed GBC n = 17). The remaining 385 patients were divided into non-SOJ (n = 234) and SOJ (n = 151) groups. Predictors of resectability and long term survival were analysed and compared with their subgroups. Results: Patients with gastric outlet obstruction, abdominal lump, weight loss and SOJ were more likely to be unresectable (p:0.04, 0.024, 0.003 and 0.003, respectively). TNM stage, node positivity and adjacent organ involvement were predictors of survival (p < 0.001, 0.008 and <0.001). Metastatic (36.7% vs 47.7%), inoperable (1.7% vs 12.6%) and unresectable disease (9.8% vs 24.5%) were more in the SOJ group and had lower curative resection rates (51.7% vs 15.2%; p < 0.0001). The 1,2 and 5-year survival rates were higher in patients in the non-SOJ than SOJ group (79.6%, 65% and 52.9% vs 48.6, 32.4% and 0%; p < 0.001). Conclusion: GBC with SOJ is more likely to be unresectable. SOJ, nodal involvement, adjacent organ infiltration and higher TNM stage predict poor survival. © 2017 Elsevier Inc.

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