Gallbladder cancer natural history

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]

Overview

Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor.

Natural History

Most tumors are adenocarcinomas, with a small percent being squamous cell carcinomas. The cancer commonly spreads to the liver, pancreas, stomach and duodenum.

Prognosis

The survival rate depends on the extent of cancer at the time of diagnosis with gallbladder cancer and Early detection is key for good prognosis

  • Gallbladder cancer has an overall 5-year survival rate less than 5%.
  • Advances in perioperative care has markedly improved outcomes.[1]
  • Recent Improvements in surgical techniques have resulted in a decline of both morbidity and mortality of the gallbladder cancer prognosis.
  • 5-year survival rate is ssen in patients who undergo R0 curative resection.[2][3]
  • Only 2–8 months survival rate has been noticed by French Surgical Association with T3/T4 tumours.
  • Hari et al. identified independent predictors such as age, tumour grade,T1 subtype, tumour histology, radiation, and surgery type.
  • The prognosis is not good for most gallbladder cancer patients if the cancer is detected in its late stages. The prognosis of gallbladder cancer also depends on the following factors.[4]
  • Among all the histological types Papillary carcinomas are having one of the best prognosis.[5]
  • Intramural invasion is seen in adenocarcinomas and are associated with worst pronosis.[6]
  • Whether or not the tumor can be removed by surgery
  • The stage of the cancer: the size of the tumor, whether the cancer has spread outside the gallbladder
  • The patient’s general health
  • Whether the cancer has just been diagnosed or has recurred.

References

  1. Lai CH, Lau WY (2008). "Gallbladder cancer--a comprehensive review". Surgeon. 6 (2): 101–10. PMID 18488776.
  2. Murakami Y, Uemura K, Sudo T, Hashimoto Y, Nakashima A, Kondo N, Sakabe R, Kobayashi H, Sueda T (2011). "Prognostic factors of patients with advanced gallbladder carcinoma following aggressive surgical resection". J. Gastrointest. Surg. 15 (6): 1007–16. doi:10.1007/s11605-011-1479-9. PMID 21547707.
  3. D'Hondt M, Lapointe R, Benamira Z, Pottel H, Plasse M, Letourneau R, Roy A, Dagenais M, Vandenbroucke-Menu F (2013). "Carcinoma of the gallbladder: patterns of presentation, prognostic factors and survival rate. An 11-year single centre experience". Eur J Surg Oncol. 39 (6): 548–53. doi:10.1016/j.ejso.2013.02.010. PMID 23522952.
  4. Kanthan R, Senger JL, Ahmed S, Kanthan SC (2015). "Gallbladder Cancer in the 21st Century". J Oncol. 2015: 967472. doi:10.1155/2015/967472. PMC 4569807. PMID 26421012.
  5. Henson DE, Albores-Saavedra J, Corle D (1992). "Carcinoma of the gallbladder. Histologic types, stage of disease, grade, and survival rates". Cancer. 70 (6): 1493–7. PMID 1516000.
  6. Kanthan R, Senger JL, Ahmed S, Kanthan SC (2015). "Gallbladder Cancer in the 21st Century". J Oncol. 2015: 967472. doi:10.1155/2015/967472. PMC 4569807. PMID 26421012.


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