WordNet

type genus of the family Cancridae (同)genus Cancer
the fourth sign of the zodiac; the sun is in this sign from about June 21 to July 22 (同)Cancer the Crab, Crab
(astrology) a person who is born while the sun is in Cancer (同)Crab
a small zodiacal constellation in the northern hemisphere; between Leo and Gemini
any malignant growth or tumor caused by abnormal and uncontrolled cell division; it may spread to other parts of the body through the lymphatic system or the blood stream (同)malignant neoplastic disease
a muscular sac attached to the liver that stores bile (secreted by the liver) until it is needed for digestion (同)gall bladder

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〈U〉〈C〉『がん』 / 〈U〉〈C〉害悪 / 《Cancer》(星座の)カニ座
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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/05/27 17:47:24」(JST)

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Gallbladder cancer is a relatively uncommon cancer. It has peculiar geographical distribution being common in central and South America, central and eastern Europe, Japan and northern India; it is also common in certain ethnic groups e.g. Native American Indians and Hispanics.^[1] If it is diagnosed early enough, it can be cured by removing the gallbladder, part of the liver and associated lymph nodes. Most often it is found after symptoms such as abdominal pain, jaundice and vomiting occur, and it has spread to other organs such as the liver. The incidence of gall bladder cancer is alarmingly increasing in China^[2] as well as north central India.^[3]

Gallbladder adenocarcinoma lymphatic invasion histopathology

According to Reinier DImalanta, it is a rare cancer that is still being studied and thought to be related to gallstones building up, which also can lead to calcification of the gallbladder, a condition known as Porcelain gallbladder. Porcelain gallbladder is also rare. Some studies indicate that people with porcelain gallbladder have a high risk of developing gallbladder cancer, but other studies question this. The outlook is poor for recovery if the cancer is found after symptoms have started to occur (being the 5-year survival rate close to 3%)

Risk factors [edit]

Gallbladder adenocarcinoma histopathology

Gender: Approx. twice more common in women than men, mostly between the ages of 50 and 60.
Obesity increases the risk for gallbladder cancer.
Primary carcinoma is linked to chronic cholecystitis and cholelithiasis.
Various single nucleotide polymorphisms (SNPs) have been shown to be associated with gallbladder cancer. However, existing genetic studies in GBC susceptibility have so far been insufficient to confirm any association.^[4]

Signs and Symptoms [edit]

Steady pain in the upper right abdomen
Weakness
Loss of appetite
Weight loss
Jaundice and vomiting due to obstruction

Early symptoms mimic gallbladder inflammation due to gallstones. Later, the symptoms may be that of biliary and stomach obstruction.

Epidemiology [edit]

Rare tumor, the U.S. incidence is 3:100000 / year
Gallbladder cancer is more common in some countries, including South American countries, Japan and Israel. In Chile gallbladder cancer is the fourth most common cause of cancer deaths.
5th most common gastrointestinal cancer
Up to 5 times more common in women than men depending on population (e.g 73% female in ^[2])

Disease Course [edit]

Most tumors are adenocarcinomas, with a small percent being squamous cell carcinomas. The cancer commonly spreads to the liver, bile duct, stomach, and duodenum.

Diagnosis [edit]

Incidentally discovered gallbladder cancer (adenocarcinoma) following a cholecystectomy. H&E stain.

Early diagnosis is not generally possible. People at high risk, such as women or Native Americans with gallstones, are evaluated closely. Transabdominal ultrasound, CT scan, endoscopic ultrasound, MRI, and MR cholangio-pancreatography (MRCP) can be used for diagnosis. A biopsy is the only certain way to tell whether the tumorous growth is malignant or not.^[5]

Treatment [edit]

The most common and most effective treatment is surgical removal of the gallbladder (cholecystectomy) with part of liver and lymph node dissection. However, with gallbladder cancer's extremely poor prognosis, most patients will die by one year following the surgery. If surgery is not possible, endoscopic stenting of the biliary tree can reduce jaundice and a stent in stomach may relieve vomiting. Chemotherapy and radiation may also be used with surgery. If gall bladder cancer is diagnosed after cholecystectomy for stone disease (incidental cancer), reoperation to remove part of liver and lymph nodes is required in most cases. When it is done as early as possible, patients have the best chance of long term survival and even cure.^[6]

References [edit]

^ Kapoor VK, McMichael AJ (2003). "Gallbladder cancer: an 'Indian' disease". Natl Med J India 16 (4): 209–13. PMID 14606770.
^ ^a ^b Hsing AW, Gao YT, Han TQ, et al. (December 2007). "Gallstones and the risk of biliary tract cancer: a population-based study in China". Br. J. Cancer 97 (11): 1577–82. doi:10.1038/sj.bjc.6604047. PMC 2360257. PMID 18000509.
^ Barbhuiya M, Singh T, Gupta S, Shrivastav B, Tiwari P (2009). "Incidence of gall bladder cancer in rural and semiurban population of north central India: A first insight". Internet Journal of Epidemiology 7 (2).
^ Srivastava K, Srivastava A, Sharma KL, Mittal B. Candidate gene studies in gallbladder cancer: a systematic review and meta-analysis. Mutat Res. 2011 Jul-Oct;728(1-2):67-79.
^ "Tests for gallbladder cancer". Cancer Research UK. Retrieved 17 September 2012.
^ Kapoor VK (March 2001). "Incidental gallbladder cancer". Am. J. Gastroenterol. 96 (3): 627–9. doi:10.1111/j.1572-0241.2001.03597.x. PMID 11280526.

External links [edit]

U.S. National Cancer Institute Gallbladder Cancer Treatment (www.cancer.gov)
The Johns Hopkins Esophageal Cancer Web page

UpToDate Contents

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1. 胆嚢癌：疫学、危険因子、臨床的特徴、および診断 gallbladder cancer epidemiology risk factors clinical features and diagnosis
2. 切除不能な進行性胆嚢癌の治療 treatment of advanced unresectable gallbladder cancer
3. 胆嚢癌の外科的マネージメント surgical management of gallbladder cancer
4. 切除後の限局性胆嚢癌に行う術後補助療法 adjuvant treatment for localized resected gallbladder cancer
5. 偶発的胆石患者へのアプローチ approach to the patient with incidental gallstones

English Journal

Epigenetic profiling of gallbladder cancer and gall stone diseases: Evaluation of role of tumour associated genes.

Singh TD1, Gupta S2, Shrivastav BR3, Tiwari PK4.
Gene.Gene.2016 Feb 1;576(2 Pt 2):743-52. doi: 10.1016/j.gene.2015.10.004. Epub 2015 Oct 8.
BACKGROUND: As on today, the global mortality rate of gallbladder cancer is still very high. Both genetic and epigenetic alterations play pivotal roles in the development of cancer. We selected seven tumour associated genes, implicated in other cancers, to assess their methylation status in gallblad
PMID 26456195

Effects of Surgical Methods and Tumor Location on Survival and Recurrence Patterns after Curative Resection in Patients with T2 Gallbladder Cancer.

Jung W1, Jang JY1, Kang MJ1, Chang YR1, Shin YC1, Chang J1, Kim SW1.
Gut and liver.Gut Liver.2016 Jan 23;10(1):140-6. doi: 10.5009/gnl15080.
BACKGROUND/AIMS: Extended cholecystectomy is generally recommended for patients with T2 gallbladder cancer. However, few studies have assessed the extent of resection relative to T2 gallbladder tumor location. This study analyzed the effects of surgical methods and tumor location on survival outcome
PMID 26347513

Japanese Journal

Complication of Chronic Eosinophilic Pneumonia in an Elderly Patient with Sjögren Syndrome

Waseda Koichi,Hagiya Hideharu,Hanayama Yoshihisa,Terasaka Tomohiro,Kimura Kosuke,Tsuzuki Takao,Hasegawa Kou,Nada Takahiro,Nakamura Eri,Murakami Kazutoshi,Kondo Eisei,Otsuka Fumio
Acta Medica Okayama 69(2), 123-127, 2015-04
… A diagnosis of advanced gallbladder cancer was made in the patientʼs clinical course, suggesting the advisability of a whole-body workup in cases of pSS, especially in elderly patients. …
NAID 120005595786