Natural history study of gallbladder cancer.A review of 36 years experience at M. D. Anderson hospital and tumor institute

Abstract

Seventy-five patients with gallbladder cancer referred to our institution over a 36-year period were studied. They represented 0.08% of all hospital admissions over the period of study. The disease was most common in older females (median age, 62 years). Ninety-seven percent of patients had a pre-existing clinical history of recurrent right upper quadrant pain suggestive of cholecystitis for a median duration of 3 years (range, 4 days to 25 years). Ninety-eight percent of patients whose records had adequate clinical, surgical or postmortem information had gallstones. Laparotomy was diagnostic in 100% of the patients. The cell type in all patients was adenocarcinoma. Surgery was curative in only 5% of patients. Results of chemotherapy, mainly 5-fluorouracil, were poor. The median survival for all patients was 5.2 months. Survival was slightly better for males, for patients younger than 62 years of age, and for patients with good performance status. At postmortem, most patients had metastases to the liver (91%) and intraabdominal lymph nodes (82%). Metastases to extraabdominal organs were infrequent.