ACR Index: 7.3
Carcinoma of the gallbladder (GB)is the sixth most common malignancy of the GI tract, following cancer of the stomach, colon, liver, esophagus, and pancreas. It predominantly affects older persons with long-standing cholecystolithiasis. GB epithelial tumors tend to behave similarly to other GI adenocarcinomas. GB tumors occur in the fundus in 60% of patients, in the body in 30% of patients, and in the neck in 10% of patients. When diagnosed incidentally at cholecystectomy, surgical resection can be curative; however, more commonly, the tumor is unresectable and rarely diagnosed preoperatively despite patients' symptoms. Early diagnosis can improve the clinical outcome and cure rate. Patients with GB carcinoma have an overall mean survival rate of 6 months, and the 5-year survival rate is 5%.
GB carcinomas are classified as:
• Malignant epithelial tumors include adenocarcinoma (most common), squamous cell carcinoma, adenosquamous carcinoma, and small cell carcinoma.
• Malignant mesenchymal tumors include embryonal rhabdomyosarcoma, leiomyosarcoma, and malignant fibrous histiocytoma.
• Other malignant tumors include carcinosarcoma, carcinoid tumor, lymphoma, and melanoma.
No established treatment protocol exists. Radical surgery with negative tumor margins is an accepted treatment for the advanced disease. According to different studies, if negative margins were seen, patients achieved a 5-year survival rate as follows:
• Stage I, 90-96%
• Stage II, 56-80%
• Stage III, 15-40%
• Stage IV, 15-16%
• Stage V, 1-6%
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