Clinical epidemiological survey of gallbladder carcinoma in northwestern China, 2009–2013: 2379 cases in 17 centers

Abstract

ObjectiveTo analyze the clinical epidemiological characteristics of patients with gallbladder carcinoma recruited from 17 hospitals in five northwestern provinces of China (Shaanxi Province, Gansu Province, Qinghai Province, Ningxia Hui Autonomous Region, and Xinjiang Uygur Autonomous Region) from 2009 to 2013, and to summarize the clinical diagnosis and treatment data of gallbladder carcinoma.MethodsClinical information of 2379 patients with gallbladder carcinoma from 17 hospitals in five northwestern provinces of China was retrospectively collected and analyzed using the “Questionnaire for Gallbladder Carcinoma Patients in Northwestern Area of China.” All information was verified with EpiData software and analyzed with SPSS 13.0 software.Results(1) Gallbladder carcinoma accounted for 2.7% (2379/86,609) of all biliary tract diseases during the study period, which was significantly higher than that from 1986 to 1998 (P < 0.001). (2) Gallbladder carcinoma was more prone to occur in elderly women. The male:female incidence ratio was 1.0:2.1, the average age of onset of disease was 63.7 ± 11.3 years, and the incidence was higher in farmers than in other occupational groups. (3) A total of 57.2% (1360/2379) of patients with gallbladder carcinoma also had gallstones. (4) Abdominal pain (1796/2379, 75.5%) and jaundice (727/2379, 30.6%) were the most common clinical manifestations, 81.2% (1527/1881) were positive in those receiving B ultrasound examinations and 90.7% (1567/1727) were positive in those undergoing computed tomography, and 64.5% (1124/1742) of patients with gallbladder carcinoma were positive for carbohydrate antigen (CA) 19-9. (5) The pathological type of gallbladder carcinoma was mainly moderately and poorly differentiated adenocarcinoma with a high degree of malignancy. At admission, 55.1% (1091/1981) of patients had stage IV cancer among patients with TNM staging information; 55.9% (1331/2379) had lymphatic metastasis, 29.7% (706/2379) had bile duct metastasis, and 53.1% (1263/2379) had liver metastasis. (6) A total of 283 patients (283/2379, 11.9%) had incidentally detected gallbladder carcinoma. (7) The rate of radical surgical resection was 30.4% (723/2379).ConclusionThe proportion of gallbladder carcinoma in biliary tract diseases in the northwestern area of China was significantly higher from 2009 to 2013 than from 1986 to 1998. Gallbladder carcinoma was common in older women and mainly diagnosed at an advanced stage. Compared with other surveys in different regions, the rate of metastasis in this survey was high, leading to a low resection rate. Populations at high risk should undergo B-ultrasound examinations at regular follow-up intervals to increase the rate of early diagnosis of gallbladder carcinoma.

A clinical epidemiological study of gallbladder carcinoma: a retrospective study

“…7 In agreement to present study, Shen HX et al, also reported that GBC was more prone to occur in elderly women. 13 In this study, the mean age was also comparable with most of the other reported studies, although in some studies it had been suggested that there was higher incidence of GBC with an older age. [14][15][16][17][18] A Chinese survey, has also reported higher mean age (63.7±11.3 years) as compared to present study mean age of 52.62±12.14 years.…”

“…[14][15][16][17][18] A Chinese survey, has also reported higher mean age (63.7±11.3 years) as compared to present study mean age of 52.62±12.14 years. 13 In the present study, most common presenting symptom of GBC was pain in right hypochondrium followed by anorexia, pruritus, weight loss and nausea and vomiting.…”

“…7 Shen HX et al, studied 2379 patients with GBC and found that 57.2% had gallstones. 13 Gallstones are reported to induce mechanical damage and carcinogens in bile that may trigger epithelial proliferation in the mucous membrane of the gall bladder which can result in malignancy. 20 Therefore, it is important to advice for surgery or regular follow-up for patients having long term history of gallbladder stones.…”

Surgical Advances in the Treatment of Gallbladder Carcinoma at Different Stages

“…When it comes to the extent of the resection, this parameter is dictated by the stage of the tumor; however, improvement of the surgical techniques in regard to liver resection and even liver transplantation as well as in regard to the perioperative management of these patients conducted to an increasing number of cases who can benefit from radical surgery for gallbladder carcinoma [14,15]. Cases presenting advanced stage disease which is no longer amenable to surgery with curative intent can also benefit from palliative procedures in order to minimize the effects of gastrointestinal or biliary obstruction [2]. In selected cases adjuvant therapies such as chemotherapy or radiotherapy might be also associated in order to improve the overall outcomes [2].…”

“…Gallbladder carcinoma represents the most frequently encountered malignant tumor originating from the biliary tract, with a low rate of diagnostic, a low rate of surgical treatment, and an extremely poor long-term prognostic [1,2].…”