Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Mar 10;14(6):1413.
doi: 10.3390/cancers14061413.

Treatment of Resectable Gallbladder Cancer

Eduardo A Vega  1 , Sebastian Mellado  2 , Omid Salehi  1 , Richard Freeman  1 , Claudius Conrad  1
Affiliations
Review

Treatment of Resectable Gallbladder Cancer

Eduardo A Vega et al. Cancers (Basel). .

Abstract

Gallbladder cancer (GBC) is the most common biliary tract cancer worldwide and its incidence has significant geographic variation. A unique combination of predisposing factors includes genetic predisposition, geographic distribution, female gender, chronic inflammation, and congenital developmental abnormalities. Today, incidental GBC is the most common presentation of resectable gallbladder cancer, and surgery (minimally invasive or open) remains the only curative treatment available. Encouragingly, there is an important emerging role for systemic treatment for patients who have R1 resection or present with stage III-IV. In this article, we describe the pathogenesis, surgical and systemic treatment, and prognosis.

Keywords: gallbladder cancer; incidental; oncologic extended resection; resectable; treatment.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Gallbladder cancer (GBC) Histology: (A) GBC, biliary type, infiltrating gallbladder (GB) wall. The top of the image shows normal GB mucosa, H&E stain, ×40; (B) gallbladder carcinoma invading muscularis propria, H&E stain, ×100; (C) perineural invasion, H&E stain, ×100; (D): Metastatic high-grade GBC to lymph node, H&E stains, G- ×100, H- ×400.
Figure 2
Figure 2
Key prognostic information in incidental gallbladder cancer (IGBC) available after the index cholecystectomy. A study of 10-year period review found that from 435 GBC patients, 391 (90%) had adenocarcinomas. Additional histologies were squamous/adenosarcoma (1.6%) and unspecified (1.1%) [34].
Figure 3
Figure 3
Oncologic extended resection (OER) should include sampling of aortocaval lymph nodes, specifically station 16b1; dissection of the hepatoduodenal ligament (station 12), common hepatic artery (station 8), and retropancreatic lymph nodes (station 13); limited resection of the liver bed or anatomic resection of liver segments IVb and V or rarely major liver resection.
Figure 4
Figure 4
Operating room set-up and scheme of port positioning in laparoscopic OER. IOUS, intraoperative ultrasound.
See this image and copyright information in PMC

References

    1. Hueman M.T., Vollmer C.M., Jr., Pawlik T.M. Evolving treatment strategies for gallbladder cancer. Ann. Surg. Oncol. 2009;16:2101–2115. doi: 10.1245/s10434-009-0538-x. - DOI - PubMed
    1. Randi G., Malvezzi M., Levi F., Ferlay J., Negri E., Franceschi S., La Vecchia C. Epidemiology of biliary tract cancers: An update. Ann. Oncol. 2009;20:146–159. doi: 10.1093/annonc/mdn533. - DOI - PubMed
    1. Shaffer E.A. Epidemiology and risk factors for gallstone disease: Has the paradigm changed in the 21st century? Curr. Gastroenterol. Rep. 2005;7:132–140. doi: 10.1007/s11894-005-0051-8. - DOI - PubMed
    1. Larsson S., Wolk A. Obesity and the risk of gallbladder cancer: A meta-analysis. Br. J. Cancer. 2007;96:1457–1461. doi: 10.1038/sj.bjc.6603703. - DOI - PMC - PubMed
    1. Pandey M., Shukla V. Lifestyle, parity, menstrual and reproductive factors and risk of gallbladder cancer. Eur. J. Cancer Prev. 2003;12:269–272. doi: 10.1097/00008469-200308000-00005. - DOI - PubMed

LinkOut - more resources