Does the presence of jaundice and/or a lump in a patient with gall bladder cancer mean that the lesion is not resectable?

Abstract

Background: The presence of jaundice or an abdominal lump in gall bladder cancer (GBC) is often translated to advanced and unresectable disease. We examined whether this was true.

Methods: We retrospectively analysed 120 GBC patients, who had been operated on, for presenting symptoms, staging and resectability. The outcomes in patients with jaundice and/or an abdominal lump were compared with those who did not have these features. Early disease was represented by stages I and II, while stages III and IV represented advanced disease.

Results: Sixty-eight patients (57%) presented with an abdominal lump and 62 (52%) had jaundice. An abdominal lump, jaundice or both were present in 89 patients (74%), of whom 78 (88%) had advanced disease, while 22 of the 31 patients (71%) with neither jaundice nor an abdominal lump had advanced disease. Forty-four patients (50%) with either or both of these features had R0 resections, while 20 patients (64%) with neither jaundice nor an abdominal lump had R0 resections. The presence of jaundice or an abdominal lump was significantly associated with advanced disease (p = 0.025), but not with unresectability (p = 1).

Conclusions: Jaundice or an abdominal lump was present in 74% of the patients with GBC. While this represented advanced-stage cancer, it did not preclude resectability.