Gall Bladder Cancer
- Gallbladder cancer is a relatively uncommon cancer. It has peculiar geographical distribution being common in central and South America, central and Eastern Europe, Japan and northern India; it is also common in certain ethnic groups e.g. Native American Indians and Hispanics.
Epidemiology and burden of Gall Bladder Cancer
- Gallbladder cancer is the 20th most common cancer in the world, with an estimated 178,100 new cases diagnosed in 2012. (http://www.wcrf.org/int/cancer-facts-figures/data-specific-cancers/gallbladder-cancer-statistics)
- The highest gallbladder cancer incidence rates worldwide in 2006 are reported for women in Delhi, India (21.5/100,000), South Karachi, Pakistan (13.8/100,000) and Quito, Ecuador (12.9/100,000). (Int J Cancer.2006 Apr 1;118(7):1591-602)
- Gallbladder cancer, though generally considered rare, is the most common malignancy of the biliary tract, accounting for 80%–95% of biliary tract cancers. (Clin Epidemiol. 2014; 6: 99–109)
- Gallbladder cancer is not usually found until it has become advanced and causes symptoms. Only about 1 of 5 gallbladder cancers is found in the early stages, when the cancer has not yet spread beyond the gallbladder. (http://www.cancer.org/cancer/gallbladdercancer/detailedguide/gallbladder-key-statistics)
Treatment for Gall Bladder Cancer
- Gemcitabine combined with carboplatin has activity against advanced biliary tract cancers (BTCs) and are comparable to other gemcitabine-platinum or gemcitabine-fluoropyrimidine combinations in advanced BTCs. (HPB (Oxford).2010 Aug;12(6):418-26)
- Gem-based combination chemotherapy had significantly higher disease response rates [OR = 1.69, 95% confidence interval (CI): 1.17-2.43; P= 0.01], a longer progression-free survival (MD = 1.95, 95%CI: 0.90-3.00; P = 0.00) and a longer overall survival (MD = 1.85, 95%CI: 0.26-3.44; P = 0.02). (World J Gastroenterol. 2014 Dec 21; 20(47): 18001–18012)
- FOLFOX-4 is an effective and well-tolerated regimen as a second-line treatment in advanced gall bladder cancer patients. (Jpn J Clin Oncol.2016 Jan;46(1):57-62)
- Options for second-line systemic therapy include GEM-FU, FU-combo, GEM-P if not given in the first-line setting. (J Gastrointest Oncol. 2014 Dec; 5(6): 408–413)
Prevention of Gall Bladder Cancer
- After adjustment for age, education and body mass index, among women, ever tea drinkers had significantly reduced risks of biliary stones (OR = 0.73, 95% CI = 0.54-0.98) and gallbladder cancer (OR = 0.56, 95% CI = 0.38-0.83). (Int J Cancer.2006 Jun 15;118(12):3089-94)
- After controlling for age, sex, education, and biliary stone status, aspirin use has been found to be associated with a reduced risk of gallbladder cancer [odds ratio (OR), 0.37; 95% confidence interval (CI), 0.17-0.88]. (Cancer Epidemiol Biomarkers Prev.2005 May;14(5):1315-8)
- A significant reduction in gallbladder cancer risk was seen with the consumption of radish (OR 0.4; 95% CI 0.17-0.94), green chilli (OR 0.45; 95% CI 0.21-0.94) and sweet potato (OR 0.33; 95% CI 0.13-0.83) among vegetables, and mango (OR 0.4; 95% CI 0.16-0.99), orange (OR; 0.45; 95% CI 0.22-0.93), melon (OR 0.3; 95% CI 0.14-0.64) and papaya (OR 0.44; 95% 0.2-0.64) among fruits. (Eur J Cancer Prev.2002 Aug;11(4):365-8)
- Factors significantly associated with GBC are illiteracy [odds ratio (OR) 8.00], lower socioeconomic status (OR 2.45), parity more than 3 (OR 9.06), age at first pregnancy less than 20 years (OR 2.03), and the use of nonliquefied petroleum gas cooking fuel (OR 4.17). Higher vitamin C intake had a protective effect (OR 0.33). (Eur J Cancer Prev.2013 Sep;22(5):431-7)
Risk factors for Gall Bladder Cancer
- Some of the important risk factors are: chemical exposure [odd ratios (OR): 7.0 (2.7-18.2)], family history of gallstones [OR: 5.3 (1.5-18.9)], tobacco [OR: 4.1 (1.8-9.7)], fried foods [OR: 3.1 (1.7-5.6)], joint family [OR: 3.2 (1.7-6.2)], long interval between meals [OR: 1.4 (1.2-1.6)]. (Int J Cancer.2013 Apr 1;132(7):1660-6)
- Risk of gallbladder cancer is approximately 4-5 times higher in patients with gallstones, than in patients without gallstones. (1999 May-Jun;46(27):1529-32)
- Age more than 55 years (OR – 7.27, p value- < 0.001), solitary stone (OR – 3.33, p value – 0.002) and stone of more than 1 cm (OR – 2.73, p value – 0.004) are found to be independent risk factors for development of gallbladder cancer. (World J Surg Oncol.2011 Dec 9;9:164)
- Compared with non-diabetic individuals, both men and women with type 2 DM had an increased risk of gallbladder cancer. (Diabetes Metab Res Rev.2016 Jan;32(1):63-72)
- Candidate gene studies in gallbladder cancer: a systematic review and meta-analysis.more..
- Number of parity and the risk of gallbladder cancer: a systematic review.more..
- Adjuvant therapy in the treatment of gallbladder cancer: a meta-analysis.more..
- A systematic review of the safety and efficacy of hepatopancreatoduodenectomy for biliary and gallbladder cancers.more..