Latest Research on Gallbladder Cancer : Dec 2020

Gallbladder cancer

Background

Gallbladder cancer (GC) is a relatively rare but highly lethal neoplasm. We review the epidemiology, etiology, pathology, symptoms, diagnosis, staging, treatment, and prognosis of GC.

Method

A Pubmed database search between 1971 and February 2007 was performed. All abstracts were reviewed and articles with GC obtained; further references were extracted by hand-searching the bibliography. The database search was done in the English language.

Results

The accurate etiology of GC remains unclear, while the symptoms associated with primary GC are not specific. Treatment with radical cholecystectomy is curative but possible in only 10% to 30% of patients. For patients whose cancer is an incidental finding on pathologic review, re-resection is indicated, where feasible, for all disease except T1a. Patients with advanced disease should receive palliative treatment. Laparoscopic cholecystectomy is contraindicated in the presence of GC.

Conclusion

Prognosis generally is extremely poor. Improvements in the outcome of surgical resection have caused this approach to be re-evaluated, while the role of chemotherapy and radiotherapy remains controversial. [1]

Gallbladder cancer worldwide: Geographical distribution and risk factors

Gallbladder cancer is a relatively rare neoplasm that shows, however, high incidence rates in certain world populations. The interplay of genetic susceptibility, lifestyle factors and infections in gallbladder carcinogenesis is still poorly understood. Age‐adjusted rates were calculated by cancer registry‐based data. Epidemiological studies on gallbladder cancer were selected through searches of literature, and relative risks were abstracted for major risk factors. The highest gallbladder cancer incidence rates worldwide were reported for women in Delhi, India (21.5/100,000), South Karachi, Pakistan (13.8/100,000) and Quito, Ecuador (12.9/100,000). High incidence was found in Korea and Japan and some central and eastern European countries. Female‐to‐male incidence ratios were generally around 3, but ranged from 1 in Far East Asia to over 5 in Spain and Colombia. History of gallstones was the strongest risk factor for gallbladder cancer, with a pooled relative risk (RR) of 4.9 [95% confidence interval (CI): 3.3–7.4]. Consistent associations were also present with obesity, multiparity and chronic infections like Salmonella typhi and S. paratyphi [pooled RR 4.8 (95% CI: 1.4–17.3)] and Helicobacter bilis and H. pylori [pooled RR 4.3 (95% CI: 2.1–8.8)]. Differences in incidence ratios point to variations in gallbladder cancer aetiology in different populations. Diagnosis of gallstones and removal of gallbladder currently represent the keystone to gallbladder cancer prevention, but interventions able to prevent obesity, cholecystitis and gallstone formation should be assessed. [2]

Gallbladder cancer — A comprehensive review

Aim: Gallbladder cancer is the fifth most common cancer involving the gastrointestinal tract, but it is the most common malignant tumour of the biliary tract worldwide. The percentage of patients diagnosed to have gallbladder cancer after simple cholecystectomy for presumed gallbladder stone disease is 0.5–1.5%. This tumour is traditionally regarded as a highly lethal disease with an overall 5-year survival of less than 5%. The marked improvement in the outcome of patients with gallbladder cancer in the last decade is because of the aggressive radical surgical approach that has been adopted, and improvements in surgical techniques and peri-operative care. This article aims to review the current approach to the management of gallbladder cancer. Methods: A Medline, PubMed database search was performed to identify articles published from 1990 to 2007 using the keywords ‘carcinoma of gallbladder’, ‘gallbladder cancer’, ‘gallbladder neoplasm’ and ‘cholecystectomy’. Results and conclusions: The overall 5-year survival for patients with gallbladder cancer who underwent R0 curative resection was reported to range from 21% to 69%. Laparoscopic cholecystectomy is absolutely contraindicated when gallbladder cancer is known or suspected pre-operatively. Patients with a pre-operative suspicion of gallbladder cancer should undergo open exploration and cholecystectomy after proper pre-operative assessment. For patients whose cancer is an incidental finding on pathological review, a second radical resection is indicated except for Tis and Tia disease. There is still controversy for the optimal management of T1b disease. Although the role of surgery for advanced disease remains controversial, patients with advanced gallbladder cancer can benefit from radical resection, provided a potentially curative R0 resection is possible. There is still no effective adjuvant therapy for gallbladder cancer. [3]

Gallbladder Carcinoma in Ghana: Histopathological Examination of Cholecystectomy Specimen

Objective: The aim of the study was to find out the incidence of gallbladder carcinoma in cholecystectomy specimen and the histological types from Korle-Bu Teaching Hospital, Ghana.

Methods: The study was a retrospective study using findings from 507 cholecystectomy specimen that were received at the Department of Pathology, Korle-Bu Teaching Hospital from 2006 – 2013.

Findings: Sixteen out of the 507 cholecystectomy specimen were malignant representing 3.15%. The commonest histological type of malignancy reported was adenocarcinoma, the mean age at presentation was 65.3 years (SD ±11.9 years) with the commonest clinical presentation being right hypochondrium pain.

Conclusion: The histopathological classification of gall bladder carcinoma in Ghanaian does not differ much from reported cases. [4]

Association between Age, Tumour Location and Survival of Patients in Morocco

Aims: Cancer is a major burden of disease worldwide. Each year, tens of millions of people are diagnosed with cancer around the world, and more than half of the patients eventually die from it. The present work aims to bring out the association between age, tumour location and survival of patients.

Methodology: The present work consists in a retrospective study carried out in an oncology Centre in Rabat and based on a sample of 1756 cases of cancer treated during the period January 2005 – December 2006.

Results: The mean age of patients is 53.49±14.98 years and men are significantly older than women. The results of the first part of this study show that patients who are between 40 and 60 years old are affected by 47.4% of all cancers. As for the influence of age on the tumour location, we noticed that testicles cancer, leukaemia and Hodgkin lymphoma affect particularly the youngest population whereas the oldest population suffers more from the cancers of prostate, bladder, liver and gall bladder. Furthermore, patients who are between 50 and 60 years old have a higher risk to die from cancer which would be due to lung and liver cancers that are known for their bad vital prognosis. Finally, we found that children and elderly people survive the least to cancer which would be attributable to their health that is rather fragile.

Conclusion: More efforts should be made by health authorities in Morocco to fight against cancer especially in age groups with bad vital prognosis. [5]

Reference

[1] Gourgiotis, S., Kocher, H.M., Solaini, L., Yarollahi, A., Tsiambas, E. and Salemis, N.S., 2008. Gallbladder cancer. The American Journal of Surgery, 196(2), pp.252-264.

[2] Randi, G., Franceschi, S. and La Vecchia, C., 2006. Gallbladder cancer worldwide: geographical distribution and risk factors. International journal of cancer, 118(7), pp.1591-1602.

[3] Lai, C.E. and Lau, W.Y., 2008. Gallbladder cancer—a comprehensive review. The surgeon, 6(2), pp.101-110.

[4] Derkyi-Kwarteng, L., Ampomah Brown, A., P. Akakpo, K., Addae, E., Amoah, D., Diabor, E. and E. Quayson, S. (2016) “Gallbladder Carcinoma in Ghana: Histopathological Examination of Cholecystectomy Specimen”, Journal of Cancer and Tumor International, 3(4), pp. 1-4. doi: 10.9734/JCTI/2016/24468.

[5] Sbayi, A., Arfaoui, A., Ait Ouaaziz, N., Habib, F. and Quyou, A. (2015) “Association between Age, Tumour Location and Survival of Patients in Morocco”, Journal of Cancer and Tumor International, 1(1), pp. 1-6. doi: 10.9734/JCTI/2014/16378.

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