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Adjuvant treatment for localized, resected gallbladder cancer

Bhoomi Mehrotra, MD
Tanios Bekaii-Saab, MD
Section Editors
Kenneth K Tanabe, MD
Stanley W Ashley, MD
Deputy Editor
Diane MF Savarese, MD


Gallbladder cancer (GBC) is an uncommon but highly fatal malignancy; fewer than 5000 new cases are diagnosed each year in the United States. Most GBC is found incidentally in patients undergoing exploration for cholelithiasis; a tumor will be found in 1 to 2 percent of such cases [1-4].

Surgery is the only potentially curative therapy for GBC. However, even after complete resection, outcomes are poor, particularly for T3 and/or node-positive disease. High rates of both local and distant recurrence have prompted interest in adjuvant chemotherapy and radiation therapy (RT). (See "Surgical management of gallbladder cancer", section on 'Outcomes' and "Surgical management of gallbladder cancer", section on 'Resectable T3/4 or node positive gallbladder cancer'.)

A high percentage of gallbladder cancers is initially unsuspected and detected at the time of laparoscopic cholecystectomy for presumed cholecystitis. The next step for these patients (before adjuvant therapy) is additional surgery to remove lymph nodes and the segments of liver above the gallbladder. (See "Surgical management of gallbladder cancer", section on 'Managing an incidental gallbladder cancer'.)

This topic review will cover adjuvant treatment for localized, resected GBC. The epidemiology, risk factors, clinical features, and diagnostic evaluation, surgical treatment, and treatment for locally advanced unresectable and metastatic GBC are covered separately, as is adjuvant treatment after resection of cholangiocarcinoma. (See "Gallbladder cancer: Epidemiology, risk factors, clinical features, and diagnosis" and "Surgical management of gallbladder cancer" and "Treatment of advanced, unresectable gallbladder cancer" and "Treatment of localized cholangiocarcinoma: Adjuvant and neoadjuvant therapy and prognosis".)


Gallbladder cancer (GBC) has traditionally been associated with a poor prognosis. Observed survival rates from a series of 10,705 cases of GBC collected between 1989 and 1996 in the National Cancer Database and stratified according to stage at diagnosis (using the newest American Joint Commission on Cancer 2010 criteria (table 1) [5]) are provided (figure 1) [6].


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Literature review current through: Feb 2017. | This topic last updated: Mon Nov 14 00:00:00 GMT+00:00 2016.
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