Twenty-year temporal trends, risk profiles, and prognostic value of clinicopathological features in gallbladder cancer following cholecystectomy.

BACKGROUND

Gallbladder cancer (GBC) is a rare but highly aggressive malignancy often diagnosed at an advanced stage. Owing to its relatively low incidence, the clinicopathologic features of GBC and its precursor lesions remain poorly understood and insufficiently explored.

AIM: To examine temporal trends and clinicopathological features in post-cholecystectomy GBC to identify risks profiles and prognostic value.

METHODS

In this retrospective study, 15785 patients who underwent cholecystectomy over a 20-year period at a single center were reviewed, among whom 285 were diagnosed with GBC. Clinicopathological features were compared among patients with benign conditions, precursor lesions, and GBC. Long-term temporal trends (2004-2023) were analyzed alongside clinicopathological characteristics and survival outcomes.

RESULTS

GBC cases increased over time (P = 0.002). Compared to benign or precancerous conditions, GBC patients were older (P = 0.000) and had higher hypertension and cholangitis rates (both P = 0.000). Total cholesterol, triglycerides, and albumin were lowest in GBC (P = 0.000, P = 0.010, P = 0.000), with higher levels linked to better survival (P = 0.003, P = 0.026, P = 0.016), and tumor budding, size, and poorly cohesive or undifferentiated components correlated with advanced stage and poorer prognosis (P = 0.015, P = 0.002, P = 0.002) on univariate analysis. Age, metabolic parameters, and inflammatory conditions influenced both GBC risk and prognosis.

CONCLUSION

The clinicopathologic characteristics of GBC highlight the value of recognizing high-risk profiles and underscore the prognostic significance of detailed histopathological evaluation.