Management of incidental gallbladder cancer in a nationwide CAPBIL study

INTRODUCTION: To provide contemporary, real-world data on the management approaches and survival outcomes of patients with incidental gallbladder cancer (GBC) following cholecystectomy in the United Kingdom. The secondary aim was to identify prognostic factors associated with survival. METHODS: Patients diagnosed with incidental GBC following cholecystectomy between January 2014 and December 2022 across 24 centres were included. Data collected comprised demographics, treatment details, histopathological findings and survival outcomes. RESULTS: During the study period, 285 patients had incidental GBC. Median follow-up was 31 months, with 5-year disease-free (DFS) and overall (OS) survival of 41.5% and 45.1%, respectively. Of the 193 (67.7%) patients who underwent liver resection, most (97.9%) underwent segment 4B/5 resection. Patients with incidental GBC who underwent liver resection had significantly improved DFS (51 vs 15 months, p<0.001) and OS (72 vs 26 months, p<0.001) compared with those who did not. In addition, patients who completed adjuvant chemotherapy had better DFS (35 vs 15 months, p=0.021) and OS (47 vs 26 months, p=0.009) compared to those who did not. On multivariable analysis, nodal metastases were independently associated with poorer DFS (HR 2.04, 95% CI 1.30-3.20, p=0.002), while advanced tumour (T3-T4) stage (HR 1.70, 95% CI 1.04-2.77, p=0.034) and nodal metastases (HR 2.15, 95% CI 1.33-3.48, p=0.002) predicted poorer OS. CONCLUSION: Patients who underwent liver resection after incidental GBC had significantly better survival than those who did not proceed to further surgery. Adverse tumour biology was associated with poorer survival.

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Publication Details

Journal
British journal of surgery
Published
2026-04-20
DOI
https://doi.org/10.1093/bjs/znag050
Primary Topic
Cholangiocarcinoma and Gallbladder Cancer Studies
Type
article
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article

Management of incidental gallbladder cancer in a nationwide CAPBIL study

Nicola Colucci, Ricky Bhogal, Nabeel Merali, Ruth Blanco‐Colino et al.
British journal of surgery
Cholangiocarcinoma and Gallbladder Cancer Studies
article

Management of incidental gallbladder cancer in a nationwide CAPBIL study

Nicola Colucci, Ricky Bhogal, Nabeel Merali, Ruth Blanco‐Colino, Danial Safavi, Sirr Ling Chin, Kai Tai Derek Yeung, Mohamed Bekheit, Michael Feretis, Tareq Alsaoudi, Dimitrios Karavias, Lawrence O’Leary, Harivinthan Sellappan, James Lucocq, FK Welsh, Hussein Nassar, Jane McClements, Lulu Tanno, Amanda Koh, Ewen M. Harrison, Lauren Blackburn, Nagappan Kumar, Nehal Shah, Omar Mownah, Daisy Evans, Dhanwant Gomez, Shahid Farid, K. Menon, Gemma Nixon, Waqqas Patel, Paris Bruno, Albasheer Hamadalnile, Rami Aljaberi, Christopher Brown, Tejinderjit Athwal, James Skipworth, Bobby V M Dasari, Adam Brooks, Adam Frampton, Adithya Pathanki, Victoria Morrison-Jones, Joel Triance, Brian Davidson, Hassan Malik, Vasilis Kosmoliaptsis, Michael Silva, Omar Abdelmohsin, Wan Teng Lee, Neil Bhardwaj, Alistair Rowcroft, Sanjay Pandanaboyana, Somaiah Aroori, J Peter A Lodge, Gabriele Marangoni
article en

Abstract

INTRODUCTION: To provide contemporary, real-world data on the management approaches and survival outcomes of patients with incidental gallbladder cancer (GBC) following cholecystectomy in the United Kingdom. The secondary aim was to identify prognostic factors associated with survival. METHODS: Patients diagnosed with incidental GBC following cholecystectomy between January 2014 and December 2022 across 24 centres were included. Data collected comprised demographics, treatment details, histopathological findings and survival outcomes. RESULTS: During the study period, 285 patients had incidental GBC. Median follow-up was 31 months, with 5-year disease-free (DFS) and overall (OS) survival of 41.5% and 45.1%, respectively. Of the 193 (67.7%) patients who underwent liver resection, most (97.9%) underwent segment 4B/5 resection. Patients with incidental GBC who underwent liver resection had significantly improved DFS (51 vs 15 months, p<0.001) and OS (72 vs 26 months, p<0.001) compared with those who did not. In addition, patients who completed adjuvant chemotherapy had better DFS (35 vs 15 months, p=0.021) and OS (47 vs 26 months, p=0.009) compared to those who did not. On multivariable analysis, nodal metastases were independently associated with poorer DFS (HR 2.04, 95% CI 1.30-3.20, p=0.002), while advanced tumour (T3-T4) stage (HR 1.70, 95% CI 1.04-2.77, p=0.034) and nodal metastases (HR 2.15, 95% CI 1.33-3.48, p=0.002) predicted poorer OS. CONCLUSION: Patients who underwent liver resection after incidental GBC had significantly better survival than those who did not proceed to further surgery. Adverse tumour biology was associated with poorer survival.

British journal of surgery
Belfast Health and Social Care Trust (GB), Cardiff and Vale University Health Board (GB), University Hospitals Birmingham NHS Foundation Trust (GB), NHS Lothian (GB), Royal Marsden NHS Foundation Trust (GB), Nottingham University Hospitals NHS Trust (GB), University of Liverpool (GB), Royal Free London NHS Foundation Trust (GB), University of Cambridge (GB), Leeds Teaching Hospitals NHS Trust (GB), University Hospitals of North Midlands NHS Trust (GB), University Hospitals Bristol NHS Foundation Trust (GB), Royal London Hospital (GB), Newcastle upon Tyne Hospitals NHS Foundation Trust (GB), University Hospital Coventry (GB), University Hospitals of Leicester NHS Trust (GB), University Hospital Southampton NHS Foundation Trust (GB), Aintree University Hospital (GB), Basingstoke and North Hampshire Hospital (GB), Bridge University (SS), Sheffield Teaching Hospitals NHS Foundation Trust (GB), King's College Hospital NHS Foundation Trust (GB), Oxford University Hospitals NHS Trust (GB), University Hospitals Plymouth NHS Trust (GB), University Hospitals Bristol and Weston NHS Foundation Trust (GB), East Lancashire Hospitals NHS Trust (GB)
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Openalex Percentile: Top 18%
Cholangiocarcinoma and Gallbladder Cancer Studies
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