[Gallbladder adenocarcinoma: tumoral staging, histological prognostic factors and survival].

Cir Esp

Servicio de Cirugía, Consorci Sanitari del Maresme, Mataró, Barcelona, Spain.

Published: January 2005

AI Article Synopsis

  • Gallbladder adenocarcinoma is a highly aggressive cancer with a poor prognosis, often diagnosed too late for curative surgery due to local tissue spread.
  • A retrospective study involving 62 patients examined various factors, such as age, sex, tumor size, and histological features, but found no significant differences in age or sex across tumor stages.
  • The study concluded that advanced tumor stages are linked to poorer cellular differentiation and worse survival outcomes, highlighting the challenges in early diagnosis and the predominance of this cancer in women.

Article Abstract

Introduction: Gallbladder adenocarcinoma is an aggressive tumor and is one of the digestive tract malignancies with the poorest prognosis. Because of loco-regional extension and delayed diagnosis, curative resection is often impossible. To determine histological prognostic factors and survival in relation to tumoral stage at diagnosis, we performed a retrospective study of our patients with gallbladder carcinoma.

Patients And Method: Sixty-two patients with gallbladder adenocarcinoma diagnosed over a 15-year period were retrospectively included in this study. The surgical procedures performed in this group of patients were laparoscopic cholecystectomy, open cholecystectomy and palliative surgery in patients with unresectable tumors. For each tumoral stage, age, sex, cellular differentiation, tumor size, the presence of metastatic nodes, histological variables linked to poor prognosis, and survival were compared.

Results: Of the 62 patients included, 45 were women and 17 were men. The mean age was 75 years. No significant differences were found in relation to age or sex among the different tumoral stages. Cellular differentiation and survival were poorer with advanced tumoral stage. A significant predominance of histological factors of poor prognosis was found in T2 and T3 tumors.

Conclusions: Preoperative diagnosis of gallbladder adenocarcinoma is difficult except in advanced cases. It is often incidentally diagnosed at histological examination of gallbladders, and shows little local advancement and a good degree of cellular differentiation. The etiology of this tumor is unknown but its prevalence is greater among women. Clinical symptoms are similar to those caused by gallstones. In this study no relationship was found between age and sex and tumoral stage. In advanced tumoral stages poor cellular differentiation is predominant as well as other histological markers of poor prognosis. Good survival was found in T3 tumors, possibly linked to good cellular differentiation. Due to high associated comorbidity, none of the patients underwent reintervention.

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http://dx.doi.org/10.1016/s0009-739x(05)70797-1DOI Listing

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