In a male after laparoscopic cholecystectomy carcinoma gall bladder stage I was detected on histopathology. What is the next appropriate management? (AIIMS Nov 2012)
|A||Conservative and follow up|
|B||Radical portal lymphadenectomy|
|C||Radiotherapy – Chemotherapy|
|D||Excises of portal site|
a. Woman are affected much more commonly than men (4:1).
b. Most patients have a history of gallstones, but very few patients with gallstones develop GB Ca.
c. Presentation is typically that of chronic cholecystitis, chronic right upper quadrant pain and weight loss.
d. Useful but nonspecific serum markers include CEA and CA 19-9. CT scans or MRCP typically reveal a gallbladder mass.
e. The mainstay of treatment s surgical, either simple or radical cholecystectomy for stages I or II and disease, respectively.
f. Survival is nearly 100% at 5 years for stage I, and ranges from 60 – 90% at 5 years for stage II.
g. Adjuvant radiotherapy, used in the presence of local lymph node disease, has not been shown to enhance survival. Similar to CCC, chemotherapy is to useful in advanced or metastatic GB Ca.