PREVALENCE OF INCIDENTAL GALLBLADDER CANCER IN A TERTIARY-CARE HOSPITAL FROM PERNAMBUCO, BRAZIL.
BACKGROUND
Gallbladder cancer is sometimes incidentally uncovered following cholecystectomy for gallstones diseases. The supposed highly variable prevalence of incidental gallbladder cancer through our country is unknown.


OBJECTIVE
To explore the prevalence of incidental gallbladder cancer in our tertiary-care hospital.


METHODS
A cross-sectional study was carried out on patients who consecutively underwent cholecystectomy due to gallstones disease at Faculdade Pernambucana de Saúde, Instituto de Medicina Integral Professor Fernando Figueira - FPS/IMIP, from January, 2007 to December, 2010. Data on incidental gallbladder cancer patients were explored for prevalence estimation and description of our experience with the management of this malignancy.


RESULTS
Our analysis involved 2018 patients with a marked predominance of women (n=1.697; 84.1%) over men (n=321; 15.9%). The 3-year prevalence estimate of 0.34% was recorded for incidental gallbladder cancer in our sample. Regarding tumor staging, there were 1 T1a, 1 T1b, and 5 T2 adenocarcinoma tumors. Laparoscopic cholecystectomy alone was performed for the T1a tumor, and additional radical surgery was performed in five others. One patient presented metastatic disease at the time of repeat surgery. The final pathology revealed residual/additional disease in all T2 tumors after radical surgery whereas the T1b patient underwent a salvage Whipple's procedure due to a secondary distal cholangiocarcinoma. The patient with T1a tumor is alive after 3-year follow-up but all of the others died because of disease recurrence/progression up to 12 months.


CONCLUSIONS
This study confirms the poor prognosis of Gallbladder cancer even when incidentally diagnosed following cholecystectomy and supposes a 3-year prevalence estimate of 0.34% for incidental gallbladder cancer in our Center from Pernambuco State, Brazil.
Departamento de Cirurgia, Faculdade Pernambucana de Saúde, Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, BR.
Euclides Dias
ED
Martins-Filho
Departamento de Cirurgia, Faculdade Pernambucana de Saúde, Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, BR.
Thales Paulo
TP
Batista
Departamento de Cirurgia, Faculdade Pernambucana de Saúde, Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, BR.
Flávio
F
Kreimer
Departamento de Cirurgia, Faculdade Pernambucana de Saúde, Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, BR.
Antonio Cavalcanti de Albuquerque
AC
Martins
Departamento de Cirurgia, Faculdade Pernambucana de Saúde, Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, BR.
Tiago Cavalcanti
TC
Iwanaga
Departamento de Cirurgia, Faculdade Pernambucana de Saúde, Instituto de Medicina Integral Professor Fernando Figueira, Recife, PE, BR.
Cristiano de Souza
Cde S
Leão
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery*; D001938:Brazil / Q000453:epidemiology; D017081:Cholecystectomy, Laparoscopic; D003430:Cross-Sectional Studies; D005260:Female; D005706:Gallbladder Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D033162:Incidental Findings; D008297:Male; D015995:Prevalence; D063128:Tertiary Health Care