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Purpose <p>To assess how obstructive jaundice and socioeconomic determinants(residence, literacy, gender) affect treatment initiation and curative surgicaleligibility among patients with gallbladder cancer in North India.</p> Methods <p>In this prospective observational cohort, adults with radiologicalor histological gallbladder cancer presenting between September 2023 and May2024 were enrolled at a tertiary cancer centre. Baseline demographics, stage,obstructive jaundice status, biliary drainage (PTBD/ERCP), treatment initiation,and surgical eligibility were recorded. Associations were examined usingchi-square and relative risk, followed by multivariable logistic regressionincluding variables with <i>p</i> &lt; 0.10.</p> Results <p>Of 1,500 enrolled patients, 1,409 were evaluable; 643 (45.6%)had obstructive jaundice. Treatment non-initiation occurred in 330/643(51.3%) with obstructive jaundice versus 24/766 (3.1%) withoutobstructive jaundice (<i>p</i> &lt; 0.001). Curative surgery was feasible in51/643 (7.9%) with obstructive jaundice compared with 223/766(29.1%) without obstructive jaundice (RR 0.27; 95% CI0.20–0.36). Illiteracy (57.6%) and rural residence (69.4%)predominated. On multivariable analysis, independent predictors of treatmentnon-initiation were obstructive jaundice (aOR 11.2; 95% CI7.6–16.5), metastatic disease at presentation (aOR 3.9; 95% CI2.1–7.4), rural residence (aOR 2.7; 95% CI 1.9–3.9), andilliteracy (aOR 1.8; 95% CI 1.3–2.6).</p> Conclusion <p>Obstructive jaundice and socioeconomic disadvantage synergisticallydrive early care discontinuity and reduce curative opportunities in gallbladdercancer, supporting decentralized decompression, patient navigation, andsocioeconomic support in high-incidence regions.</p>

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RETRACTED ARTICLE: Impact of Obstructive Jaundice and Socioeconomic Determinants on Outcomes in Gallbladder Cancer: A Prospective Cohort Study

  • 期刊论文

  • 发表日期：

    2026年1月31日

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  • Kumar Vineet,
  • Mayank Tripathi,
  • Dhaval R. Vadodaria,
  • Chandan Kumar,
  • Divya Khanna

摘要

Purpose

To assess how obstructive jaundice and socioeconomic determinants(residence, literacy, gender) affect treatment initiation and curative surgicaleligibility among patients with gallbladder cancer in North India.

Methods

In this prospective observational cohort, adults with radiologicalor histological gallbladder cancer presenting between September 2023 and May2024 were enrolled at a tertiary cancer centre. Baseline demographics, stage,obstructive jaundice status, biliary drainage (PTBD/ERCP), treatment initiation,and surgical eligibility were recorded. Associations were examined usingchi-square and relative risk, followed by multivariable logistic regressionincluding variables with p < 0.10.

Results

Of 1,500 enrolled patients, 1,409 were evaluable; 643 (45.6%)had obstructive jaundice. Treatment non-initiation occurred in 330/643(51.3%) with obstructive jaundice versus 24/766 (3.1%) withoutobstructive jaundice (p < 0.001). Curative surgery was feasible in51/643 (7.9%) with obstructive jaundice compared with 223/766(29.1%) without obstructive jaundice (RR 0.27; 95% CI0.20–0.36). Illiteracy (57.6%) and rural residence (69.4%)predominated. On multivariable analysis, independent predictors of treatmentnon-initiation were obstructive jaundice (aOR 11.2; 95% CI7.6–16.5), metastatic disease at presentation (aOR 3.9; 95% CI2.1–7.4), rural residence (aOR 2.7; 95% CI 1.9–3.9), andilliteracy (aOR 1.8; 95% CI 1.3–2.6).

Conclusion

Obstructive jaundice and socioeconomic disadvantage synergisticallydrive early care discontinuity and reduce curative opportunities in gallbladdercancer, supporting decentralized decompression, patient navigation, andsocioeconomic support in high-incidence regions.