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Gallbladder Cancer

Updated : April 22, 2024





Background

Gallbladder cancer (GC) is an uncommon cancer that accounts for about half of all biliary tract cancers. According to data from a 2007 analysis of 10301 patients, at a 5-year survival rate of 17.6% biliary tumors are highly deadly malignancies.

Due to the reasons stated below, gallbladder cancer has a generally unfavorable diagnosis:

  • Late presentation
  • Aggressive nature of tutor
  • Complex anatomic position
  • Diagnosis at an advanced stage

The treatment for locally progressed and metastatic illness is palliative chemotherapy. In contrast, early-stage disease may be curable with surgical resection and adjuvant therapy.

Epidemiology

As a result of the high incidence of chronic gallbladder infections and gallstones, the incidence rate of gallbladder cancer is greater in certain populations outside the US. In 2017, the American Cancer Society projects 11,740 new cases of gallbladder cancer and 3,830 fatalities, with a preponderance of females.

Over the past few decades, the incidence of gallbladder cancer has reduced in individuals aged over 50 but increased in younger patients. African Americans are less at risk at developing gall bladder cancer, when compared to Southwestern Native Americans, Mexican Americans, and the general white population.

Anatomy

Pathophysiology

Current hypothesis demonstrates that persistent inflammation of bile duct tissue accumulates consecutive genetic alterations, resulting in transformation into cancer. The most often documented mutations are K-ras oncogenes and beta-catenin tumor suppressors (CTNNB1). The research has not uncovered any inherited familial risk.

Approximately 90% of histopathological alterations in gallbladder cancer are adenocarcinomas. After roughly 15 years of inflammation, this syndrome evolves from pre-neoplastic dysplasia to carcinoma in site and, finally, to invasive carcinoma. Squamous cell carcinoma of the gallbladder is uncommon.

Etiology

The greatest risk factor for developing gallbladder cancer is chronic inflammation. Cholelithiasis or gall stones are the biggest predictors for gallbladder cancer. The chronicity, size of the gallstones and the number of symptoms affects the risk for developing gallbladder cancer.  Gallbladder calcification, often known as porcelain gallbladder, is frequently associated with persistent cholelithiasis.

This problem is typically discovered inadvertently during imaging and frequently results in cholecystectomy. Other risk factors for gallbladder cancer include gallbladder polyps, congenital biliary cysts, and aberrant pancreaticobiliary anatomy. All of these lead to chronic inflammation, which ultimately results in gallbladder cancer.

Salmonella typhi and helicobacter endemic regions are associated with chronic asymptomatic carriers and an increased risk of gallbladder cancer. In addition, carcinogens such methyldopa, isoniazid, occupational exposure to substances like radon and methylcellulose, and lifestyle choices might cause gallbladder cancer.

Some examples of these include smoking, obesity, high intake of carbohydrates. Two diseases which greatly increase for gallbladder cancer are IBS and chronic primary sclerosing cholangitis.

Genetics

Prognostic Factors

Based on individuals diagnosed with gallbladder cancer between 2011-2017, the overall 5-year survival rate is extremely poor at 19%. This is due to the cancer generally being diagnosed at an advanced stage.

The 5-year survival rate for gall bladder cancer with distant spread is only 2%, and for cancer with regional spread the same is 28%. Localized gall bladder cancers have a much better 5-year survival rate at 66%, but the cancer is rarely diagnosed at this stage.

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

Media Gallary

References

https://pubmed.ncbi.nlm.nih.gov/17109082/

https://www.ncbi.nlm.nih.gov/books/NBK442002/

https://www.cancer.org/cancer/gallbladder-cancer/detection-diagnosis-staging/survival-rates.html

Gallbladder Cancer

Updated : April 22, 2024




Gallbladder cancer (GC) is an uncommon cancer that accounts for about half of all biliary tract cancers. According to data from a 2007 analysis of 10301 patients, at a 5-year survival rate of 17.6% biliary tumors are highly deadly malignancies.

Due to the reasons stated below, gallbladder cancer has a generally unfavorable diagnosis:

  • Late presentation
  • Aggressive nature of tutor
  • Complex anatomic position
  • Diagnosis at an advanced stage

The treatment for locally progressed and metastatic illness is palliative chemotherapy. In contrast, early-stage disease may be curable with surgical resection and adjuvant therapy.

As a result of the high incidence of chronic gallbladder infections and gallstones, the incidence rate of gallbladder cancer is greater in certain populations outside the US. In 2017, the American Cancer Society projects 11,740 new cases of gallbladder cancer and 3,830 fatalities, with a preponderance of females.

Over the past few decades, the incidence of gallbladder cancer has reduced in individuals aged over 50 but increased in younger patients. African Americans are less at risk at developing gall bladder cancer, when compared to Southwestern Native Americans, Mexican Americans, and the general white population.

Current hypothesis demonstrates that persistent inflammation of bile duct tissue accumulates consecutive genetic alterations, resulting in transformation into cancer. The most often documented mutations are K-ras oncogenes and beta-catenin tumor suppressors (CTNNB1). The research has not uncovered any inherited familial risk.

Approximately 90% of histopathological alterations in gallbladder cancer are adenocarcinomas. After roughly 15 years of inflammation, this syndrome evolves from pre-neoplastic dysplasia to carcinoma in site and, finally, to invasive carcinoma. Squamous cell carcinoma of the gallbladder is uncommon.

The greatest risk factor for developing gallbladder cancer is chronic inflammation. Cholelithiasis or gall stones are the biggest predictors for gallbladder cancer. The chronicity, size of the gallstones and the number of symptoms affects the risk for developing gallbladder cancer.  Gallbladder calcification, often known as porcelain gallbladder, is frequently associated with persistent cholelithiasis.

This problem is typically discovered inadvertently during imaging and frequently results in cholecystectomy. Other risk factors for gallbladder cancer include gallbladder polyps, congenital biliary cysts, and aberrant pancreaticobiliary anatomy. All of these lead to chronic inflammation, which ultimately results in gallbladder cancer.

Salmonella typhi and helicobacter endemic regions are associated with chronic asymptomatic carriers and an increased risk of gallbladder cancer. In addition, carcinogens such methyldopa, isoniazid, occupational exposure to substances like radon and methylcellulose, and lifestyle choices might cause gallbladder cancer.

Some examples of these include smoking, obesity, high intake of carbohydrates. Two diseases which greatly increase for gallbladder cancer are IBS and chronic primary sclerosing cholangitis.

Based on individuals diagnosed with gallbladder cancer between 2011-2017, the overall 5-year survival rate is extremely poor at 19%. This is due to the cancer generally being diagnosed at an advanced stage.

The 5-year survival rate for gall bladder cancer with distant spread is only 2%, and for cancer with regional spread the same is 28%. Localized gall bladder cancers have a much better 5-year survival rate at 66%, but the cancer is rarely diagnosed at this stage.

https://pubmed.ncbi.nlm.nih.gov/17109082/

https://www.ncbi.nlm.nih.gov/books/NBK442002/

https://www.cancer.org/cancer/gallbladder-cancer/detection-diagnosis-staging/survival-rates.html