Clinical epidemiologic characteristics of 430 cases of gallbladder cancer

To make clear the incidence, clinical characteristics and possible regional difference of gallbladder cancer in China.

A total of 430 cases of gallbladder cancer from 28 hospitals between 1986-1996 were reviewed, according to a standard protocol called "the clinical epidemiological list of gallbladder cancer".

The incidence of gallbladder cancer was higher in the females than in the males. There was significant difference in the incidence between the north and south of China, and between the mountain area and flatlands. Gallbladder cancer accounted for 1.6% of bile tract disease in the same period. Gallstones were found in about 50% of the cases of gallbladder cancer. The clinical symptoms included abdominal pain, ictus, etc. The major pathohistologic type was adenocarcinoma, and 58% of tumors were localized in the whole gallbladder. Metastasis occurred mainly along the biliary tract or directly to the bed of gallbladder and liver. Ultrasonography and CT were useful to diagnosis. The positive imaging diagnostic rate was higher in 1991-1996 than in 1986-1990 P < 0.05) [corrected]. The rate of operative resection was 100% for stage I and II disease, 75% for stage III and IV, and significantly lower for stage V (P < 0.05). The 3-year survival rate in patients with stage I or II disease was significantly higher than that in those with terminal cancer (P < 0.05).

There is specific populational, time and regional difference in the distribution of gallbladder cancer. Ultrasonography and CT are the most important diagnostic methods. Early diagnosis and early radical resection are the key to increasing the 5-year survival rate.