DOI: 10.54005/geneltip.2004811 ISSN: 2602-3741

Incidental and Non-Incidental Gallbladder Carcinoma: A Retrospective Comparison of Clinicopathological Characteristics and Survival Outcomes

Tugba Gunler, İlknur Küçükosmanoğlu, Yaşar Ünlü, Gürcan Şimşek, Meral Büyükterzi
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Aim: Incidental gallbladder carcinoma (IGBC) refers to malignancies detected during histopathological examination following cholecystectomy performed for benign indications. Although IGBC is generally diagnosed earlier, its impact on survival remains unclear. We compared the clinicopathological characteristics and overall survival outcomes of patients with IGBC and non-incidental gallbladder carcinoma (NIGBC) and evaluated independent prognostic factors affecting survival.Materials and Methods: A total of 69 patients histopathologically diagnosed with gallbladder carcinoma between January 2008 and December 2019 were retrospectively reviewed. Patients were grouped by mode of diagnosis as IGBC (n=40) or NIGBC (n=29). Clinical, surgical, and histopathological characteristics were compared. Overall survival was analyzed using the Kaplan-Meier method, and prognostic factors were evaluated using univariable and multivariable Cox regression analyses.Results: Among 12,938 cholecystectomies performed during the study period, IGBC was identified in 40 cases (0.31%). The median tumor size was significantly smaller in the IGBC group than in the NIGBC group (19 mm vs. 35 mm, p<0.001). In addition, early pT stage (pT1–2) was significantly more frequent in the IGBC group (p<0.001). Among patients with available pathological nodal assessment, Stage I–II disease was also more frequent in the IGBC group than in the NIGBC group (55.6% vs. 20.7%; p=0.014). The presence of gallstones and the rate of laparoscopic surgery were also significantly higher in the IGBC group (p<0.001 for both). No significant difference in overall survival was observed between the groups (log-rank p=0.589). In the multivariable analysis, age, advanced pT stage, and initial surgical margin positivity were identified as independent factors associated with overall survival. Incidental diagnosis was not significantly associated with overall survival in the multivariable analysis.Conclusions: Although patients with IGBC were diagnosed with smaller tumors and at an earlier pT stage, a statistically significant survival advantage associated with incidental diagnosis was not demonstrated in this cohort. Instead, age, advanced pT stage, and initial surgical margin positivity were significantly associated with overall survival.

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