Surgical treatment of gallbladder cancer

Aim. To analyze current literature sources on gallbladder cancer and to study the long-term outcomes of treatment for this disease.

Materials and methods. The study involved a retrospective analysis of the treatment results of 33 patients with histologically confirmed gallbladder cancer.

Results. At the preoperative stage, the diagnosis of gallbladder cancer was established in 19 patients (58%), while 11 cases (33%) were diagnosed with portal cholangiocarcinoma, cholangiocellular carcinoma, and hepatocellular carcinoma. Malignant neoplasms were diagnosed in 30 cases (91%) prior to surgery. Resectional procedures were performed in 21 patients (64%), with R0 resection achieved in 7 cases (21%) and R1 surgery performed in 11 patients (33%). The average duration of hospital stay after surgery amounted to 15.6 (1–71) days. The median survival time accounted for 10.5 months.

Conclusion. The detection and treatment of gallbladder cancer are associated with considerable challenges. Ensuring early and accurate diagnosis and radical surgical intervention stands as a primary aspect to develop. Given the aggressive nature of the tumor, research into the biological characteristics of this type of cancer may hold significant potential.

1. Wang C.C., Tsai M.C., Wang S.C., Peng C.M., Lee H.L., Chen H.Y., Yang T.W., Lin C.C., Sung W.W. Favorable gallbladder cancer mortality-to-incidence ratios of countries with good ranking of world’s health system and high expenditures on health. BMC Public Health. 2019; 19 (1): 1025. https://doi.org/10.1186/s12889-019-7160-z

2. Shukla S.K., Singh G., Shahi K.S., Bhuvan Pant P. Staging, treatment, and future approaches of gallbladder carcinoma. J. Gastrointest. Cancer. 2018; 49 (1): 9–15. https://doi.org/10.1007/s12029-017-0036-5

3. Krell R.W., Wei A.C. Gallbladder cancer: surgical management. Chin. Clin. Oncol. 2019; 8 (4): 36. https://doi.org/10.21037/cco.2019.06.06

4. Schmidt M.A., Marcano-Bonilla L., Roberts L.R. Gallbladder cancer: epidemiology and genetic risk associations. Chin. Clin. Oncol. 2019; 8 (4): 31. https://doi.org/10.21037/cco.2019.08.13

5. Okladnikov S.M., Glotko O.L., Ivanova A.M., Moruga A.S., Nikitina S.Yu., Strakhova E.V., Fatyanova L.N., Chumarina V.Zh., Elefterova M.P. Zhenshchiny i muzhchiny Rossii [Women and men in Russia]. 2020. Moscow: Rosstat, 2022. 208 p. (In Russian)

6. Ferlay J., Ervik M., Lam F., Laversanne M., Colombet M., Mery L., Piñeros M., Znaor A., Soerjomataram I., Bray F. Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer [сайт]. https:// gco.iarc.who.int/today; 2024 [обновлено 08 февраля 2024; процитировано 24 апреля 2024] Доступно: https://gco.iarc.who.int/today/en/dataviz/strip-chart?mode=population&cancers=12&populations=903_904_905_908_909_926_935

7. Bray F., Laversanne M., Sung H., Ferlay J., Siegel R.L., Soerjomataram I., Jemal A. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 2024; 74 (3): 229–263. https://doi.org/10.3322/caac.21834

8. Tonkikh Yu.L., Vasyutin A.V., Tsukanov V.V. Gallbladder cancer: incidence, risk factors, diagnostics. Doctor.Ru. 2024; 23 (1): 46–50. https://doi.org/10.31550/1727-2378-2024-23-1-46–50 (In Russian)

9. Singh J., Shukla D., Gupta S., Shrivastav B.R., Tiwari P.K. Clinical epidemiology of gallbladder cancer in North-Central India and association of immunological markers, NLR, MLR and PLR in the diagnostic/prognostic prediction of GBC. Cancer Treat. Res. Commun. 2021; 28: 100431. https://doi.org/10.1016/j.ctarc.2021.100431

10. Wiles R., Thoeni R.F., Barbu S.T., Vashist Y.K., Rafaelsen S.R., Dewhurst C., Arvanitakis M., Lahaye M., Soltes M., Perinel J., Roberts S.A. Management and follow-up of gallbladder polyps: Joint guidelines between the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), European Association for Endoscopic Surgery and other Interventional Techniques (EAES), International Society of Digestive Surgery – European Federation (EFISDS) and European Society of Gastrointestinal Endoscopy (ESGE). Eur. Radiol. 2017; 27 (9): 3856–3866. https://doi.org/10.1007/s00330-017-4742-y

11. Chatterjee A., Lopes Vendrami C., Nikolaidis P., Mittal P.K., Bandy A.J., Menias C.O., Hammond N.A., Yaghmai V., Yang G.Y., Miller F.H. Uncommon intraluminal tumors of the gallbladder and biliary tract: spectrum of imaging appearances. Radiographics. 2019; 39 (2): 388–412. https://doi.org/10.1148/rg.2019180164

12. Krell R.W., Wei A.C. Gallbladder cancer: surgical management. Chinese Clin. Oncol. 2019; 8 (4): 36. https://doi.org/10.21037/cco.2019.06.06

13. Roa J.C., Garcia P., Kapoor V.K., Maithel S.K., Javle M., Koshiol J. Gallbladder cancer. Nat. Rev. Dis. Primers. 2022; 8 (1): 69. https://doi.org/10.1038/s41572-022-00398-y

14. Roa J.C., Garcia P., Kapoor V.K., Maithel S.K., Javle M., Koshiol J. Publisher correction: gallbladder cancer. Nat. Rev. Dis. Primers. 2022; 8 (1): 75. https://doi.org/10.1038/s41572-022-00408-z

15. Gupta P., Meghashyam K., Marodia Y., Gupta V., Basher R., Das C.K., Yadav T.D., Irrinki S., Nada R., Dutta U. Locally advanced gallbladder cancer: a review of the criteria and role of imaging. Abdom. Radiol. (NY). 2021; 46 (3): 998–1007. https://doi.org/10.1007/s00261-020-02756-4

16. Foley K.G., Lahaye M.J., Thoeni R.F., Soltes M., Dewhurst C., Barbu S.T., Vashist Y.K., Rafaelsen S.R., Arvanitakis M., Perinel J., Wiles R., Roberts S.A. Management and follow-up of gallbladder polyps: updated joint guidelines between the ESGAR, EAES, EFISDS and ESGE. Eur. Radiol. 2022; 32 (5): 3358–3368. https://doi.org/10.1007/s00330-021-08384-w

17. John S., Moyana T., Shabana W., Walsh C., McInnes M.D.F. Gallbladder cancer: imaging appearance and pitfalls in diagnosis [Formula: see text]. Can. Assoc. Radiol. J. 2020; 71 (4): 448–458. https://doi.org/10.1177/0846537120923273

18. Ramachandran A., Srivastava D.N., Madhusudhan K.S. Gallbladder cancer revisited: the evolving role of a radiologist. Br. J. Radiol. 2021; 94 (1117): 20200726. https://doi.org/10.1259/bjr.20200726

19. Lopes Vendrami C., Magnetta M.J., Mittal P.K., Moreno C.C., Miller F.H. Gallbladder carcinoma and its differential diagnosis at MRI: what radiologists should know. Radiographics. 2021; 41 (1): 78–95. https://doi.org/10.1148/rg.2021200087

20. Neculoiu D., Neculoiu L.C., Popa R.M., Manea R.M. The Many hidden faces of gallbladder carcinoma on CT and MRI imaging – from A to Z. Diagnostics (Basel). 2024; 14 (5): 475. https://doi.org/10.3390/diagnostics14050475

21. National Comprehensive Cancer Network. Biliary tract cancers (Version 3.2024). [сайт]. https://www.nccn.org/home; 2024 [обновлено 30 августа 2023; процитировано 5 мая 2024] Доступно: https://www.nccn.org/professionals/physician_gls/pdf/btc.pdf

22. Obshcherossijskaya obshchestvennaya organizaciya “Rossijskoe obshchestvo klinicheskoj onkologii”, Obshcherossijskij nacional'nyj soyuz “Associaciya onkologov Rossii”. Rak zhelchevyvodyashchej sistemy [All-Russian Public Organization “Russian Society of Clinical Oncology”, All-Russian National Union “Association of Oncologists of Russia”. Gallbladder cancer. Clinical recommendations]. Clinical guidelines. 2020; 23 p.

23. Vega E.A., De Aretxabala X., Qiao W., Newhook T.E., Okuno M., Castillo F., Sanhueza M., Diaz C., Cavada G., Jarufe N., Munoz C., Rencoret G., Vivanco M., Joechle K., Tzeng C.D., Vauthey J.N., Vinuela E., Conrad C. Comparison of oncological outcomes after open and laparoscopic re-resection of incidental gallbladder cancer. Br. J. Surg. 2020; 107 (3): 289–300. https://doi.org/10.1002/bjs.11379

24. Kuipers H., Hoogwater F.J., Holtman G.A., van der Hoorn A., de Boer M.T., de Haas R.J. Clinical value of diffusion-weighted MRI for differentiation between benign and malignant gallbladder disease: a systematic review and meta-analysis. Acta Radiol. 2021; 62 (8): 987–996. https://doi.org/10.1177/0284185120950115

25. Lv T.R., Liu F., Hu H.J., Regmi P., Ma W.J., Yang Q., Jin Y.W., Li F.Y. The role of extra-hepatic bile duct resection in the surgical management of gallbladder carcinoma. A first meta-analysis. Eur. J. Surg. Oncol. 2022; 48 (3): 482–491. https://doi.org/10.1016/j.ejso.2021.11.131

26. Kuipers H., de Bitter T.J.J., de Boer M.T., van der Post R.S., Nijkamp M.W., de Reuver P.R., Fehrmann R.S.N., Hoogwater F.J.H. Gallbladder cancer: current insights in genetic alterations and their possible therapeutic implications. Cancers (Basel). 2021; 13 (21): 5257. https://doi.org/10.3390/cancers13215257

27. Sachan A., Saluja S.S., Nekarakanti P.K., Nimisha, Mahajan B., Nag H.H., Mishra P.K. Raised CA19–9 and CEA have prognostic relevance in gallbladder carcinoma. BMC Cancer. 2020; 20 (1): 826. https://doi.org/10.1186/s12885-020-07334-x