Gallbladder carcinoma: Institutional experience—Is this a rare disease?

Abstract

e14550 Background: Gallbladder cancer (GC) is the most common neoplasm of the bile ducts, is the 5 most common of the digestive tract. There is geographical variability, the highest rates are observed in Chile, Bolivia, Mexico, India and Pakistan. It was suggested that low socioeconomic status may delay access to cholecystectomy, which would increase the risk of GC. The Objective is to determine the population characteristics and therapeutic management of patients (pts) diagnosed of GC in our Institution. Methods: We analyzed the files of pathology and medical reports of pts diagnosed with GC in our Hospital, from January 2001 to August 2010. Results: We collected 77 pathology reports. Median age: 58 years (36 - 88). 58 women and 19 men, ratio 3.1/1. Adenocarcinoma was the most frequent histological type (85.9%).Depth of Tumor Invasion: pTx (16.9%); pTis (1.3%), pT1 (2.6 %), pT2 (41.5%), pT3 (27.3%), pT4 (5.2%) and unknown (5.2%). Stages: EI (25%), EII-III (18.7%), EIV (37.2%); unknown (19.1%).We analyzed medical records of 48 pts. Clinical presentation: pain in right upper quadrant (54.2%), jaundice (18.75%) right upper quadrant pain and jaundice (16.6%) and incidental diagnosis (10.4%). Only 9 pts have had an oncological surgery as first treatment. The 56.2% (n = 28) received an oncologic treatment: radiotherapy: 35.8% (n = 10), radiochemotherapy 5FU-based; 17.9% (n = 5). Chemotherapy: first-line: 61% (n = 17), second line, 9% (n = 5). Gemcitabine-based regimen in 65% and based on 5-FU in 35%. Median survival: 6.5 months. An evaluation of the records of 9 years of pathology in our hospital showed a high incidence of gallbladder tumors (n=77), being the third cause of cancer after colorectal (n=111) and esophagus (n=103). Conclusions: Age of diagnosis, sex, clinical presentation, histological type, pattern of spread (liver) and median survival were similar to previously reported in the literature. The frequence of GC was higher than expected which is an alarming situation because of its high mortality. We should make strategies for precocious diagnosis and appropriate treatment and conduct investigations to determine the causes of this high incidence.