Spreads of gallbladder carcinoma: significance of histological classification of the tumor

Mode of spread of the primary gallbladder carcinoma was investigated in 40 curatively operated and 91 non-curatively operated patients. Fifty-seven percent of curatively operated patients showed papillary adenocarcinoma (pap.) and 44% of non-curatively operated patients did poorly differentiated tubular adenocarcinoma in histology. The curatively operated patients who showed pap. had the best prognosis, showing 5-year survival rate of 67%. It could be pointed out that pap. tended to limit in the gallbladder wall, since 61% and 74% of pap. showed negative serosal infiltration and hepatic invasion, respectively. Tubular adenocarcinoma (tub.), in contrast, tended to spread to adjacent viscera, since only 23% of cases showed negative serosal infiltration. In non-curatively operated patients, there was no significant difference in the survival period among different histological types of the tumor. Even in pap. with advanced stage, incidences of lymph node metastasis, invasion to the bile duct and peritoneal dissemination were closely similar to those in tub.. In conclusion, histological type of the tumor strongly influenced the spread of carcinoma and an outcome of the patients, consequently.