[Cancer of the gallbladder. Epidemiology, diagnosis and prognostic factors]

Between 1978 and 1986, 77 cases of primary gallbladder carcinoma were recorded in the Calvados Digestive tumors Registry (covering a population of 589,559 inhabitants) among 125 extra-hepatic bile duct carcinomas. The crude incidence was 2.4/100,000 in females and 0.6 in males (sex-ratio = 3.8). Cholelithiasis was demonstrated in 81.3%. Gallbladder carcinoma was diagnosed correctly preoperatively in only 13.5%. Out of the 74 operated patients, there were only 6 mucosal or sub-mucosal carcinomas and liver involvement was present in 40%. Diagnosis was made post-operatively on the resected specimen in 13 patients (non reoperated) Operative mortality was 24%. The overall survival was 14.7% at one year, 4% at 5 years (median = 3 months). In multivariate analysis the prognostic factors were: curative resection (9 patients, 3-year survival: 55%), parietal extension, liver involvement. No significant trend in prognosis could be demonstrated during the study period.