Gallbladder cancer overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]
Overview
Classification
Gallbladder cancer may be classified according to histology findings into various subtypes.
Pathophysiology
The pathophysiology of gallbladder cancer depends on the histologic subtypes.
Epidemiology and Demographics
In 2015, the number of new cases of gallbladder cancer was estimated to be 10,910 in United States. Females are more commonly affected with gallbladder cancer than males, the female to male ratio is approximately 5 to 1.
Risk factors
Common risk factors in the development of gallbladder cancer are obesity, chronic cholecystitis, chronic cholelithiasis, chronic typhoid infection, alcohol and genetic mutations.
Screening
There is no screening recommended for gallbladder cancer.
Differential Diagnosis
Gallbladder cancer must be differentiated from hepatitis, gallstones, cholecystitis, peptic ulcer, pancreatic cancer and pancreatitis.
Natural history, Complications and prognosis
Depending on the extent of the tumor at the time of diagnosis, the prognosis is generally regarded as poor.
Staging
According to the AJCC, there are 4 stages of gallbladder cancer based on the tumor spread.
History and symptoms
Symptoms of gallbladder cancer include jaundice, pain, fever, burping and weight loss.
Laboratory findings
Laboratory findings consistent with the diagnosis of gallbladder cancer include abnormal liver function tests and elevated CA 19-9 and CEA levels.
CT
On abdominal CT scan, gallbladder cancer appears as large heterogeneous mass with areas of necrosis.
MRI
MRI combined with magnetic resonance cholangiography may be helpful in the diagnosis of gallbladder cancer metastasis.
Other imaging findings
PET scan may be helpful in the diagnosis of gallbladder cancer.
Medical therapy
The therapy for gallbladder cancer depends largely on the disease progression and the stage of cancer.
Surgery
The mainstay of therapy for gallbladder cancer is surgery.
Palliative treatment
Palliative therapy in gallbladder cancer involves percutaneous transhepatic radiologic catheter bypass or endoscopically placed stents, standard external-beam radiation therapy, palliative surgery or standard chemotherapy.
Primary Prevention
Research suggests that lifestyle factors such as changes in diet, exercise, and maintenance of weight can influence the likelihood of an individual developing gallbladder cancer.