Gallbladder cancer (GBC) is one of the most common cancers of the biliary tract, and it is often associated with a poor prognosis, especially in its advanced stages. The median survival rate for those with advanced GBC is approximately five months, and early recurrence (ER) is a frequent occurrence, affecting up to one-third of patients. The majority of patients with gallbladder cancer present with advanced disease, which is typically not amenable to curative surgery. While surgery remains the only potential cure for GBC, only about 25% of patients qualify for resection due to the advanced nature of their condition. As oncologic surgery has become more complex, the decision-making process has grown more difficult. This process now requires not only high-level technical skills but also careful patient selection to ensure that surgical interventions offer meaningful benefits while minimizing unnecessary risks.

In a new study conducted at Boston University Chobanian & Avedisian School of Medicine (Boston, MA, USA), researchers have identified key risk factors that may predict when surgery for gallbladder cancer will not be beneficial, leading to ER or complications. The study analyzed data from 788 patients who underwent surgery for GBC across 18 international hospitals. The researchers compared patients who experienced a positive outcome after surgery with those whose surgery was deemed ineffective, meaning they either had an early recurrence (within five months) or died within 90 days. Using statistical models, the researchers identified three major risk factors that increase the likelihood of futile surgery: advanced tumor stage (T3-T4), involvement of lymph nodes, and the need for multi-organ resection. According to the researchers, this study, published in the Annals of Surgical Oncology, offers significant insights into the treatment of gallbladder cancer and surgical decision-making, emphasizing the importance of careful patient selection before surgery.

“Our findings provide doctors with a tool to assess whether surgery is the best option for a patient with gallbladder cancer. Using this predictive model, surgeons can avoid operations that are unlikely to help and instead explore alternative treatments, such as chemotherapy or other targeted therapies,” said corresponding author Eduardo Vega, MD, assistant professor of surgery. “Additionally, the concept of personalized, data-driven decision-making could be extended to other cancers where aggressive surgery is debated.” 

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