ABSTRACT
PURPOSE: To identify clinical and pathologic differences between nonadvanced (resectable by cholecystectomy) gallbladder adenocarcinomas (GBA) and advanced (nonresectable) GBA. PATIENTS AND 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.
