Trends in incidence and management of gallbladder carcinoma: a population-based study in France.
BACKGROUND
Little is known, at a population level, about the incidence and management of gallbladder carcinoma. The objective of this study was to determine trends in incidence, treatment, stage at diagnosis, and prognosis of gallbladder carcinoma in a well defined population.


METHODS
A series of 484 patients diagnosed over a 20-year period (1976-1995) in a French well defined population was used. Incidence rates were calculated by gender, age groups, and 5-year periods. Prognosis was determined using crude and relative survival rates. A multivariate relative survival analysis was performed.


RESULTS
Age-standardized incidence rates were 0.8 per 100,000 inhabitants for men and 1.5 per 100,000 inhabitants for women. There were no significant time trends in incidence in both genders. The proportion of cases resected for cure increased from 18. 1% (1976-1980) to 42.4% (1991-1995) (P < 0.001) as well as the proportion of cases limited to the gallbladder wall, respectively from 15.7% to 27.8% (P < 0.001). Relative survival rates were 16.6% at 1 year and 6.2% at 5 years. Age, stage at diagnosis, and period of diagnosis significantly influenced the prognosis of gallbladder carcinoma. The 5-year relative survival rate rose from 2.7% (1976-1985) to 10.2% (1986-1995). The multivariate analysis showed that age and stage at diagnosis were independent prognostic factors.


CONCLUSIONS
This study demonstrated that gallbladder carcinoma incidence is stable in France and that substantial advances in its management have been achieved, but there is evidence that further improvements are necessary to increase survival.
Manfredi
S
S
Registre Bourguignon des Cancers Digestifs (Institut National de la Santé et de la Recherche Médicale [INSERM] CRI 9505), Faculté de Médecine, Dijon Cedex, France.
Benhamiche
A M
AM
Isambert
N
N
Prost
P
P
Jouve
J L
JL
Faivre
J
J
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D018672:Community Health Planning; D005260:Female; D005602:France / Q000453:epidemiology; D005706:Gallbladder Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012042:Registries; D016019:Survival Analysis