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Gallbladder Cancer

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Surgical Oncology Manual

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Abstract

Gallbladder cancer is an aggressive though rare disease in the Western population, with great incidence variability compared to countries in East Asia and South America. It is a silent malignancy, developing in a chronically inflamed gallbladder mucosa, most generally defined by gallstones disease.

Almost 50% of patients with gallbladder cancer are diagnosed unexpectedly after a cholecystectomy for benign acute/chronic cholecystitis.

Curative treatment is limited among these incidentally diagnosed patients with important residual disease or those with evidence of locally advanced disease on initial presentation.

Most data arise from retrospective studies with reduced number of patients, with mixed histologies, including cholangiocarcinoma.

The lack of randomized clinical trials (RCT) focused on gallbladder cancer creates a burden to determine the best, evidence-based multimodal approach.

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References

  1. Sharma A, et al. Gallbladder cancer epidemiology, pathogenesis and molecular genetics: recent update. World J Gastroenterol. 2017;23(22):3978–98.

    PubMed  PubMed Central  Google Scholar 

  2. Wernberg JA, Lucarelli DD. Gallbladder cancer. Surg Clin North Am. 2014;94(2):343–60.

    PubMed  Google Scholar 

  3. Diehl AK. Epidemiology of gallbladder cancer: a synthesis of recent data. J Natl Cancer Inst. 1980;65(6):1209–14.

    CAS  PubMed  Google Scholar 

  4. Lowenfels AB, et al. Gallstones and risk of gallbladder cancer. J Natl Cancer Inst. 1985;75(1):77–80.

    CAS  PubMed  Google Scholar 

  5. Lowenfels AB, et al. Gallstone growth, size, and risk of gallbladder cancer: an interracial study. Int J Epidemiol. 1989;18(1):50–4.

    CAS  PubMed  Google Scholar 

  6. Zatonski WA, et al. Epidemiologic aspects of gallbladder cancer: a case-control study of the SEARCH Program of the International Agency for Research on Cancer. J Natl Cancer Inst. 1997;89(15):1132–8.

    CAS  PubMed  Google Scholar 

  7. Lowenfels AB, et al. Epidemiology of gallbladder cancer. Hepato-Gastroenterology. 1999;46(27):1529–32.

    CAS  PubMed  Google Scholar 

  8. Serra I, Diehl AK. Number and size of stones in patients with asymptomatic and symptomatic gallstones and gallbladder carcinoma. J Gastrointest Surg. 2002;6(2):272–3.

    PubMed  Google Scholar 

  9. Randi G, Franceschi S, La Vecchia C. Gallbladder cancer worldwide: geographical distribution and risk factors. Int J Cancer. 2006;118(7):1591–602.

    CAS  PubMed  Google Scholar 

  10. Moller H, et al. Obesity and cancer risk: a Danish record-linkage study. Eur J Cancer. 1994;30A(3):344–50.

    CAS  PubMed  Google Scholar 

  11. Calle EE, et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348(17):1625–38.

    Google Scholar 

  12. Kimura K, et al. Association of gallbladder carcinoma and anomalous pancreaticobiliary ductal union. Gastroenterology. 1985;89(6):1258–65.

    CAS  PubMed  Google Scholar 

  13. Nuzzo G, et al. Papillary carcinoma of the gallbladder and anomalous pancreatico-biliary junction. Report of three cases and review of the literature. Hepato-Gastroenterology. 2005;52(64):1034–8.

    PubMed  Google Scholar 

  14. Dutta U, et al. Typhoid carriers among patients with gallstones are at increased risk for carcinoma of the gallbladder. Am J Gastroenterol. 2000;95(3):784–7.

    CAS  PubMed  Google Scholar 

  15. Misra S, et al. Carcinoma of the gallbladder. Lancet Oncol. 2003;4(3):167–76.

    PubMed  Google Scholar 

  16. Caygill C, et al. Increased risk of biliary tract cancer following gastric surgery. Br J Cancer. 1988;57(4):434–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Fong Y, Jarnagin W, Blumgart L. Gallbladder cancer: comparison of patients presenting initially for definitive operation with those presenting after prior noncurative intervention. Ann Surg. 2000;232:4.

    Google Scholar 

  18. Goetze TO, Paolucci V. Prognosis of incidental gallbladder carcinoma is not influenced by the primary access technique: analysis of 837 incidental gallbladder carcinomas in the German Registry. Surg Endosc. 2013;27(8):2821–8.

    PubMed  Google Scholar 

  19. Foster JM, et al. Gallbladder cancer: defining the indications for primary radical resection and radical re-resection. Ann Surg Oncol. 2007;14(2):833–40.

    PubMed  Google Scholar 

  20. Vega EA, et al. Incidental versus non-incidental gallbladder cancer: index cholecystectomy before oncologic re-resection negatively impacts survival in T2b tumors. HPB (Oxford). 2019;21(8):1046–56.

    Google Scholar 

  21. Alexander F, et al. Biliary carcinoma. A review of 109 cases. Am J Surg. 1984;147(4):503–9.

    CAS  PubMed  Google Scholar 

  22. Oertli D, Herzog U, Tondelli P. Primary carcinoma of the gallbladder: operative experience during a 16 year period. Eur J Surg. 1993;159(8):415–20.

    CAS  PubMed  Google Scholar 

  23. Wade TP, et al. Experience with distal bile duct cancers in U.S. Veterans Affairs hospitals: 1987-1991. J Surg Oncol. 1997;64(3):242–5.

    CAS  PubMed  Google Scholar 

  24. de Groen PC, et al. Biliary tract cancers. N Engl J Med. 1999;341(18):1368–78.

    PubMed  Google Scholar 

  25. Shukla PJ, et al. Does PET-CT scan have a role prior to radical re-resection for incidental gallbladder cancer? HPB (Oxford). 2008;10(6):439–45.

    Google Scholar 

  26. Corvera CU, et al. 18F-fluorodeoxyglucose positron emission tomography influences management decisions in patients with biliary cancer. J Am Coll Surg. 2008;206(1):57–65.

    PubMed  Google Scholar 

  27. Leung U, et al. Impact of pre-operative positron emission tomography in gallbladder cancer. HPB (Oxford). 2014;16(11):1023–30.

    Google Scholar 

  28. Tian Y, et al. Diagnostic role of staging laparoscopy in a subset of biliary cancers: a meta-analysis. ANZ J Surg. 2017;87(1–2):22–7.

    PubMed  Google Scholar 

  29. Butte JM, et al. The role of laparoscopic staging in patients with incidental gallbladder cancer. HPB (Oxford). 2011;13(7):463–72.

    Google Scholar 

  30. Kondo S, et al. Regional and para-aortic lymphadenectomy in radical surgery for advanced gallbladder carcinoma. Br J Surg. 2000;87(4):418–22.

    CAS  PubMed  Google Scholar 

  31. Ohtani T, Shirai Y, Tsukada K, Muto T, Hatakeyama K. Spread of gallbladder carcinoma: CT evaluation with pathologic correlation. Abdom Imaging. 1996;21(3):195–201.

    CAS  PubMed  Google Scholar 

  32. Noji T, et al. CT evaluation of paraaortic lymph node metastasis in patients with biliary cancer. J Gastroenterol. 2005;40(7):739–43.

    PubMed  Google Scholar 

  33. Agarwal AK, et al. Role of routine 16b1 lymph node biopsy in the management of gallbladder cancer: an analysis. HPB (Oxford). 2014;16(3):229–34.

    Google Scholar 

  34. Amin MB, editor. AJCC Cancer Staging Manual. 8th ed: Switzerland: Springer; 2017.

    Google Scholar 

  35. Koga A, et al. Diagnosis and operative indications for polypoid lesions of the gallbladder. Arch Surg. 1988;123(1):26–9.

    CAS  PubMed  Google Scholar 

  36. Park JY, et al. Long-term follow up of gallbladder polyps. J Gastroenterol Hepatol. 2009;24(2):219–22.

    PubMed  Google Scholar 

  37. Ouchi K, Mikuni J, Kakugawa Y. Laparoscopic cholecystectomy for gallbladder carcinoma: results of a Japanese survey of 498 patients. J Hepato-Biliary-Pancreat Surg. 2002;9(2):256–60.

    Google Scholar 

  38. Weiland ST, et al. Should suspected early gallbladder cancer be treated laparoscopically? J Gastrointest Surg. 2002;6(1):50–6.

    PubMed  Google Scholar 

  39. Cleary SP, et al. Cancer of the gallbladder and extrahepatic bile ducts. Curr Probl Surg. 2007;44(7):396–482.

    PubMed  Google Scholar 

  40. Ouchi K, et al. Laparoscopic cholecystectomy for gallbladder carcinoma: results of a Japanese survey of 498 patients. J Hepato-Biliary-Pancreat Surg. 2002;9(2):256–60.

    Google Scholar 

  41. Lee SE, et al. Practical guidelines for the surgical treatment of gallbladder cancer. J Korean Med Sci. 2014;29(10):1333–40.

    PubMed  PubMed Central  Google Scholar 

  42. Hawkins WG, et al. Jaundice predicts advanced disease and early mortality in patients with gallbladder cancer. Ann Surg Oncol. 2004;11(3):310–5.

    PubMed  Google Scholar 

  43. Vega EA, et al. Positive cystic duct margin at index cholecystectomy in incidental gallbladder cancer is an important negative prognosticator. Eur J Surg Oncol. 2019;45(6):1061–68.

    Google Scholar 

  44. Butte JM, et al. Residual disease predicts outcomes after definitive resection for incidental gallbladder cancer. J Am Coll Surg. 2014;219(3):416–29.

    PubMed  PubMed Central  Google Scholar 

  45. Vinuela E, et al. Incidental gallbladder cancer: residual cancer discovered at oncologic extended resection determines outcome: a report from high- and low-incidence countries. Ann Surg Oncol. 2017;24(8):2334–43.

    PubMed  Google Scholar 

  46. Vega EA, et al. Extended lymphadenectomy is required for incidental gallbladder cancer independent of cystic duct lymph node status. J Gastrointest Surg. 2018;22(1):43–51.

    PubMed  Google Scholar 

  47. Wakai T, Shirai Y, Hatakeyama K. Radical second resection provides survival benefit for patients with T2 gallbladder carcinoma first discovered after laparoscopic cholecystectomy. World J Surg. 2002;26(7):867–71.

    PubMed  Google Scholar 

  48. Paolucci V, Neckell M, Gotze T. Unsuspected gallbladder carcinoma--the CAE-S/CAMIC registry. Zentralbl Chir. 2003;128(4):309–12.

    CAS  PubMed  Google Scholar 

  49. Ethun CG, et al. Routine port-site excision in incidentally discovered gallbladder cancer is not associated with improved survival: a multi-institution analysis from the US Extrahepatic Biliary Malignancy Consortium. J Surg Oncol. 2017;115(7):805–11.

    PubMed  PubMed Central  Google Scholar 

  50. Fong Y, Heffernan N, Blumgart LH. Gallbladder carcinoma discovered during laparoscopic cholecystectomy: aggressive reresection is beneficial. Cancer. 1998;83(3):423–7.

    CAS  PubMed  Google Scholar 

  51. Muratore A, et al. Gallbladder cancer invading the perimuscular connective tissue: results of reresection after prior non-curative operation. J Surg Oncol. 2003;83(4):212–5.

    PubMed  Google Scholar 

  52. Pawlik TM, et al. Incidence of finding residual disease for incidental gallbladder carcinoma: implications for re-resection. J Gastrointest Surg. 2007;11(11):1478–86; discussion 1486-7.

    PubMed  Google Scholar 

  53. Nimura Y, et al. Hepatopancreatoduodenectomy for advanced carcinoma of the biliary tract. Hepato-Gastroenterology. 1991;38(2):170–5.

    CAS  PubMed  Google Scholar 

  54. Wakai T, et al. Combined major hepatectomy and pancreaticoduodenectomy for locally advanced biliary carcinoma: long-term results. World J Surg. 2008;32(6):1067–74.

    PubMed  Google Scholar 

  55. Doty JR, et al. Cholecystectomy, liver resection, and pylorus-preserving pancreaticoduodenectomy for gallbladder cancer: report of five cases. J Gastrointest Surg. 2002;6(5):776–80.

    PubMed  Google Scholar 

  56. Choi SB, et al. Surgical strategy for T2 and T3 gallbladder cancer: is extrahepatic bile duct resection always necessary? Langenbeck's Arch Surg. 2013;398(8):1137–44.

    Google Scholar 

  57. Wiggers JK, et al. Patterns of recurrence after resection of gallbladder cancer without routine extrahepatic bile duct resection. HPB (Oxford). 2014;16(7):635–40.

    Google Scholar 

  58. Shukla PJ, Barreto SG. Systematic review: should routine resection of the extra-hepatic bile duct be performed in gallbladder cancer? Saudi J Gastroenterol. 2010;16(3):161–7.

    PubMed  PubMed Central  Google Scholar 

  59. Baron TH. Expandable metal stents for the treatment of cancerous obstruction of the gastrointestinal tract. N Engl J Med. 2001;344(22):1681–7.

    CAS  PubMed  Google Scholar 

  60. Wagholikar GD, et al. Early gallbladder cancer. J Am Coll Surg. 2002;194(2):137–41.

    PubMed  Google Scholar 

  61. Wakai T, et al. Early gallbladder carcinoma does not warrant radical resection. Br J Surg. 2001;88(5):675–8.

    CAS  PubMed  Google Scholar 

  62. Taner CB, Nagorney DM, Donohue JH. Surgical treatment of gallbladder cancer. J Gastrointest Surg. 2004;8(1):83–9.

    PubMed  Google Scholar 

  63. Sasaki R, et al. Significance of extensive surgery including resection of the pancreas head for the treatment of gallbladder cancer—from the perspective of mode of lymph node involvement and surgical outcome. World J Surg. 2006;30(1):36–42.

    PubMed  Google Scholar 

  64. Valle J, et al. Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med. 2010;362(14):1273–81.

    CAS  PubMed  Google Scholar 

  65. Primrose JN, et al. Capecitabine compared with observation in resected biliary tract cancer (BILCAP): a randomised, controlled, multicentre, phase 3 study. Lancet Oncol. 2019;20(5):663–73.

    Google Scholar 

  66. Kresl JJ, et al. Adjuvant external beam radiation therapy with concurrent chemotherapy in the management of gallbladder carcinoma. Int J Radiat Oncol Biol Phys. 2002;52(1):167–75.

    PubMed  Google Scholar 

  67. Cho JY, et al. Laparoscopic approach for suspected early-stage gallbladder carcinoma. Arch Surg. 2010;145(2):128–33.

    PubMed  Google Scholar 

  68. Shirobe T, Maruyama S. Laparoscopic radical cholecystectomy with lymph node dissection for gallbladder carcinoma. Surg Endosc. 2014;29(8):2244–50.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Complex General Surgical Oncology, University of Toronto, Toronto, ON, Canada

    Nicolas Devaud

  2. Department of Surgery, University of Toronto, Toronto, ON, Canada

    Natalie G. Coburn & Melanie E. Tsang

Authors
  1. Nicolas Devaud
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  2. Natalie G. Coburn
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  3. Melanie E. Tsang
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Corresponding author

Correspondence to Melanie E. Tsang .

Editor information

Editors and Affiliations

  1. Department of Surgery, University of Toronto, Toronto, ON, Canada

    Frances C. Wright

  2. Department of Surgery, University of Toronto, Toronto, ON, Canada

    Jaime M. Escallon

  3. Department of Surgery, University of Toronto, Toronto, ON, Canada

    Moises Cukier

  4. Department of Surgery, University of Toronto, Toronto, ON, Canada

    Melanie E. Tsang

  5. Department of Surgery, University of Toronto, Toronto, ON, Canada

    Usmaan Hameed

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Devaud, N., Coburn, N.G., Tsang, M.E. (2020). Gallbladder Cancer. In: Wright, F., Escallon, J., Cukier, M., Tsang, M., Hameed, U. (eds) Surgical Oncology Manual. Springer, Cham. https://doi.org/10.1007/978-3-030-48363-0_10

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  • DOI: https://doi.org/10.1007/978-3-030-48363-0_10

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