Gallbladder Adenocarcinoma: Morbidity, Mortality, and Survival of Patients Operated at the Brazilian National Cancer Institute

With the aim of evaluating morbidity, mortality, survival, and prognostic factors of gallbladder adenocarcinoma, we carried out a retrospective analysis of 97 patients with this condition, treated in the Abdomino-Pelvic Surgery Section of the National Cancer Institute, from June 1997 to January 2023. The predominant sex was female, with 83 women (85.5%) and 14 men (14.5%). The average age was 62 years. Regarding ethnicity, there were 50 White patients (51.5%), 31 Brown patients (32%), 13 Black patients (13.4%), and one Yellow ethnicity. Of these patients, 62% had symptoms, with the most common complaints being abdominal pain (24%), jaundice (24%), weight loss (13%), and abdominal mass (14%). Forty-eight percent of patients had suspicious imaging tests for the diagnosis of gallbladder cancer, visualized on ultrasound, computed tomography, or magnetic resonance imaging, while 51% were found on pathology or were operated on for cholelithiasis. A total of 64.9% of patients had previous cholelithiasis on some imaging exam. Sixty patients (61.9%) underwent their first surgery outside INCa and were referred for additional surgery. The most common degree of tumor differentiation was G2 (56.7%), followed by G1 18.6%, G3. The total resectability rate (R0 and R1) was 62.9% (61 patients). Thirty-four R0 surgeries (35.1%), 24 R1 surgeries (27.8%), and 36 R2 surgeries (37.1%) were performed. The only histological type found was adenocarcinoma. The average 5-year overall survival of patients was 19.7 months. There is a significant worsening of the drop in survival when comparing the staging of this disease, according to the eighth edition of the AJCC. Patients with stage I have an estimated survival of 62 months, stage II 46 months, stage III 11 months, and stage IV 2 months.