Shukla et al developed the Tata Memorial Hospital Scoring System (TMHSS) for evaluating a patient with gallbladder cancer. This can be used to help to guide management of the patient. The authors are from Tata Memorial Hospital in Mumbai, India.
Parameters:
(1) CA 19-9 concentration
(2) serum total bilirubin concentration
(3) CT scan findings
Parameter |
Finding |
Points |
---|---|---|
CA 19-9 |
<= 30 U/mL (normal) |
1 |
|
30.1 to 90 U/mL (3x ULN) |
2 |
|
90.1 to 450 U/mL (15x ULN) |
3 |
|
> 450 U/mL |
4 |
serum total bilirubin |
<= 3 mg/dL |
0 |
|
> 3 mg/dL |
2 |
CT scan findings |
normal |
0 |
|
mass in the gallbladder |
1 |
|
liver infiltration |
2 |
|
intrahepatic biliary radicle dilatation or medially placed mass |
3 |
|
metastatic disease |
4 |
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the worse the prognosis.
Total Score |
Resectable? |
Management |
---|---|---|
<= 3 |
probably |
surgery with staging laparotomy |
4 to 6 |
possibly |
surgery with staging and neoadjuvant options |
>= 7 |
unlikely |
palliative care with chemotherapy and stenting |
Purpose: To evaluate a patient with gallbladder cancer using the Tata Memorial Hospital Scoring System (TMHSS).
Specialty: Hematology Oncology, Surgery, general, Gastroenterology
Objective: clinical diagnosis, including family history for genetics, criteria for diagnosis, severity, prognosis, stage, options, response to therapy
ICD-10: C23,