Gallbladder cancer (GBC) is the most frequent neoplasm of the biliary tract, appearing essentially in Latin America, unlike in western regions, including Portugal. Its prognosis is poor and the 5-year survival varies between 16% to 20%.
Contribute to the characterization of GBC in Portugal through a retrospective analysis of patients with GBC registered at the CHUSJ, in the last 10 years.
Material and Methods
Data from 55 clinical files were reviewed according to the CHUSJ Registry of Tumors from January 2007 to December 2017, regarding the following variables: age, gender, symptomatology, risk factors, stage, type of surgery, morbidity and survival.
There was a higher incidence in women (67.3%), the mean age was 67 years and in 60% of the cases were associated to lithiasis. Among the 55 neoplasms analyzed, 12 (21.8%) were considered unresectable.
On the 43 patients operated, the performed surgery corresponded to 25 laparoscopic cholecystectomies and 18 open cholecystectomies, of which 19 and 10 were associated with bisegmentectomies IV and V, respectively. The diagnosis of GBC was incidental in 29 cases (67.4%). Immediate postoperative morbidity was reported in 4 cases (9.3%) with 3 deaths (7%). The overall survival rate was 36, 43 and 6 months, in all the patients, in the operated and in the unresectable, respectively. Survival after 1, 3 and 5 years after surgery was 60.4%, 34.9% and 18.6%, respectively.
Discussion / Conclusion
Gallbladder cancer is very uncommon in western regions, including Portugal, unlike in Latin American countries such as Chile and Bolivia.
Our results confirm their poor prognosis with a non-negligible incidence of irresectability and low survival in the operated patients. Simple or radical cholecystectomy is the only recommended therapy, with an increasing use of the laparoscopic approach. Its diagnosis was incidental in an appreciable number of cases, and it is recommended to perform early surgery in the gallbladder pathology associated with risk factors.