Relation of histopathological features to prognosis of gallbladder cancer

Sixty-four cases of gallbladder cancer surgically removed were histologically divided into three groups, that is, papillary adenocarcinoma, tubular adenocarcinoma, and undifferentiated carcinoma, and were compared clinicopathologically. The results are as follows. Papillary adenocarcinoma showed little gender preponderance and had a low association with gallstones. Underlying chronic cholecystitis or epithelial metaplasia was infrequent. Most cases were in the early stage, with favorable prognosis. Tubular adenocarcinoma, seen predominantly in females with gallstones, showed a downward invasive growth with unfavorable prognosis. Chronic cholecystitis and epithelial metaplasia were frequent. Undifferentiated carcinomas were common in females with gallstones, and their prognosis was the worst of the three. It was concluded that papillary adenocarcinoma differed from both tubular adenocarcinoma and undifferentiated carcinoma in biological behavior. The former appears to arise mainly from the native gallbladder epithelium, whereas the latter two types frequently arise from metaplastic epithelium.