RISK FACTORS AND SECONDARY PREVENTION OF GALLBLADDER CANCER
Andrea Cariati, San Martino and IST Hospitals
5 August 2013
Authors: Cariati A, Piromalli E.
In a recent number of WJSO an interesting article on the risk factors of gallbladder cancer in Karachi has been published (1). We agree with almost all Authors conclusions but some considerations could be necessary.
In fact, gallbladder cancers have been found in association with long-standing cholesterol gallstones, gallstones larger than 1 cm, gender (female), age (old age) as in western countries (2) but, in order to understand the different associate conditions related with these tumours we suggested to distinguish squamous-cell from non-squamous cell carcinomas (3). Moreover, in the conclusion the Authors proposed to use prophylactic cholecystectomy for the secondary prevention of gallbladder cancer among asymptomatic populations with gallstones. Previously we demonstrated that prophylactic cholecystectomy would almost triplicate the costs of the public health for the treatment of biliary diseases (4) and that, at the moment, it could be proposed only in selected high risk group patients as: patients with porcelain gallbladder (5), patients with cholesterol or combination stones larger than 3 cm (6), patients with gallbladder polyps larger than 1 cm (7).
References
1) Alvi AR, Siddiqui NA, Zafar H. Risk factors of gallbladder cancer in Karachi a case-control study. World J Surg Oncol 2011; 9: 164
2) Lazcan-Ponce EC, at al. Epidemiology and molecular pathology of gallbladder cancer. Ca Cancer J Clin 2011; 51: 349-364
3) Cariati A, Cetta F. Squamous-cell and non-squamous-cell carcinomas of the gallbladder have different risk factors. The Lancet Oncology 2003; 4: 393-394
4) Cariati A. Cost analysis of secondary prevention of gallbladder cancer. CA Cancer J Clin 2005 (web only) http://caonline.amcancersoc.org/cgi/eletters/51/6/349
5) Stephen AE, et al. Carcinoma in the porcelain gallbladder: a relationship revisited. Surgery 2001; 129: 699-703
6) Lowenfels AB, et al. Gallstone growth, size, and risk of gallbladder carcinoma: an interracial study. Internal J Epidemiol 1989; 18: 50-54
7) Aldridge MC et al. Gallbladder cancer. the polyp cancer sequence. Br J Surg 1990; 77: 363-364
RISK FACTORS AND SECONDARY PREVENTION OF GALLBLADDER CANCER
5 August 2013
Authors: Cariati A, Piromalli E.
In a recent number of WJSO an interesting article on the risk factors of gallbladder cancer in Karachi has been published (1). We agree with almost all Authors conclusions but some considerations could be necessary.
In fact, gallbladder cancers have been found in association with long-standing cholesterol gallstones, gallstones larger than 1 cm, gender (female), age (old age) as in western countries (2) but, in order to understand the different associate conditions related with these tumours we suggested to distinguish squamous-cell from non-squamous cell carcinomas (3). Moreover, in the conclusion the Authors proposed to use prophylactic cholecystectomy for the secondary prevention of gallbladder cancer among asymptomatic populations with gallstones. Previously we demonstrated that prophylactic cholecystectomy would almost triplicate the costs of the public health for the treatment of biliary diseases (4) and that, at the moment, it could be proposed only in selected high risk group patients as: patients with porcelain gallbladder (5), patients with cholesterol or combination stones larger than 3 cm (6), patients with gallbladder polyps larger than 1 cm (7).
References
1) Alvi AR, Siddiqui NA, Zafar H. Risk factors of gallbladder cancer in Karachi a case-control study. World J Surg Oncol 2011; 9: 164
2) Lazcan-Ponce EC, at al. Epidemiology and molecular pathology of gallbladder cancer. Ca Cancer J Clin 2011; 51: 349-364
3) Cariati A, Cetta F. Squamous-cell and non-squamous-cell carcinomas of the gallbladder have different risk factors. The Lancet Oncology 2003; 4: 393-394
4) Cariati A. Cost analysis of secondary prevention of gallbladder cancer. CA Cancer J Clin 2005 (web only) http://caonline.amcancersoc.org/cgi/eletters/51/6/349
5) Stephen AE, et al. Carcinoma in the porcelain gallbladder: a relationship revisited. Surgery 2001; 129: 699-703
6) Lowenfels AB, et al. Gallstone growth, size, and risk of gallbladder carcinoma: an interracial study. Internal J Epidemiol 1989; 18: 50-54
7) Aldridge MC et al. Gallbladder cancer. the polyp cancer sequence. Br J Surg 1990; 77: 363-364
Competing interests
None declared