Gallbladder cancer risk factors
Gallbladder cancer (BC) ranks fifth among malignant neoplasms of the gastrointestinal tract. The high mortality rate and poor prognosis are largely associated with late diagnosis. At an early stage, patients with RGD most often present non-specific complaints or do not present them at all.
Approximately 50-70% of cases of RPL are incidental findings during cholecystectomy performed for a benign neoplasm. And the major part (60-80%) is diagnosed at early stages.
That is why there has appeared a necessity to analyze the incidence of IBD in order to determine the predictors of high risk for this malignant disease. This should be the basis for oncologic alertness and appropriate preparation before surgical intervention (optimal decision-making speed depending on pathomorphological findings, readiness for extended cholecystectomy and lymphodissection).
The American College of Surgeons staff analyzed all patients who underwent cholecystectomy between 2007 and 2017. Interventions due to suspected BCI were excluded.
The study included 403,443 patients who underwent cholecystectomy, with 441 (0.11%) having RPL. The majority of the 375,487 (93.1%) cholecystectomies were performed laparoscopically. About 46% of the cholecystectomies that resulted in a diagnosis of RPL were eventually performed via open access. In addition, cholecystectomies performed for RPL had a significantly longer mean operative time (106.0 minutes) compared with cholecystectomies performed for benign pathology (60.0 minutes).
Preoperative risk factors for detecting BC were identified: age older than 60 years (OR (odds ratio) 6.51), female gender (OR 1.75), weight loss (OR 2.58) and elevated alkaline phosphatase level (OR 1.67).
Thus, the obtained data have a great contribution to the surgical oncological alertness concerning RPL and allow to identify the groups of patients with the high risk of detection of this malignant neoplasm.