[Primary carcinoma of the gallbladder]

Determine the general features of primary gallbladder carcinoma (GBC), the diagnostic procedure and the current management as well as to analyze the experience at the National Institute of Cancer in Mexico City (INCan).

GBC is a rare and frequently lethal disease. The majority of patients are diagnosed at late clinical stages when the prognosis is poor. However in recent years several investigators have shown that radical procedures increase survival.

A review of relevant articles regarding epidemiological features, laboratory and imaging studies together with the actual form of management according to the stage at diagnosis was made. A review of clinical records of patients with GBC at the INCan in the last 10 years was also made.

The prognosis of GBC carcinoma depends of the stage at the time of diagnosis, tumors confined to the gallbladder (Nevin I-III) have better prognosis than those presented with lymphadenopathy or liver invasion. Actually the surgical procedure most accepted is wedge liver resection and lymphadenectomy, because it seems to improve survival. At the INCan one hundred patients were analyzed of which only six were diagnosed with lesion Nevin I all alive with a mean follow up of 33 months, with lesions Nevin II five out of 13 are alive and were treated with wedge liver resection or radiotherapy, lesion Nevin III only 4 alive and received radiotherapy. Patients with lesions Nevin IV and V have the poorest prognosis.

GBC is a highly lethal disease. Early diagnosis make possible to perform radical resections and improve survival.