title: Natural history of gallbladder carcinoma: clinical and pathologic factors.
abstract: OBJECTIVE
  To identify clinical and pathologic differences between nonadvanced (resectable by cholecystectomy) gallbladder adenocarcinomas (GBA) and advanced (nonresectable) GBA.
  
  
  METHODS
  Twenty-nine cases of GBA were divided into two groups. Patients in group A (n = 15) underwent complete tumor resection by cholecystectomy, and those in group B (n = 14), incomplete or no resection of the tumor. Clinical (age, sex, pain, jaundice, weight loss, abdominal mass, fever), biological (anemia, hypoalbuminemia, cholestasis-cytolysis), diagnostic (ultrasound, intraoperative, postoperative) and pathologic (tumor size and differentiation status) aspects were compared in the two groups.
  
  
  RESULTS
  Clinical and biological factors showed no significant differences between the two groups. Overall effectiveness of GC diagnosis before the postoperative pathologic examination was 6.7% in group A and 57.1% in group B (p < 0.001). Advanced tumors (T3-T4) were found in group B, and nonadvanced tumors in group A (T1-T2, 66.7%). In group B well-differentiated tumors (10 cases) predominated, whereas poorly-differentiated tumors predominated in group A (19 cases, p < 0.01).
  
  
  CONCLUSIONS
  The preoperative diagnosis of GBA is difficult, except in advanced cases. No clinical differences exist between completely resected and nonresectable tumors. Resected tumors are usually a postoperative pathologic finding, and are usually nonadvanced and well differentiated.
authors.affiliation: Servicio de Cirugía General, Consorci Sanitari de Mataró, Barcelona.
authors.forename: L A
authors.initials: LA
authors.lastname: Hidalgo Grau
authors.forename: J M
authors.initials: JM
authors.lastname: Badia Pérez
authors.forename: A
authors.initials: A
authors.lastname: Heredia Budó
authors.forename: C
authors.initials: C
authors.lastname: Admella Salvador
authors.forename: R
authors.initials: R
authors.lastname: Muns Sala
authors.forename: J M
authors.initials: JM
authors.lastname: Gubern Nogués
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy; D003937:Diagnosis, Differential; D005260:Female; D005704:Gallbladder / Q000473:pathology; D005706:Gallbladder Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies