Gallbladder Cancer Follow-up

  • Author: Mary Denshaw-Burke, MD, FACP; Chief Editor: Jules E Harris, MD   more...
 
Updated: Jan 13, 2012
 

Further Outpatient Care

  • Because survival is usually very short in patients with advanced disease, close follow-up is essential to preserve the best quality of life. For patients with earlier stage disease who are treated with surgery and postoperative radiation therapy and chemotherapy, intermittent posttreatment imaging studies can be considered (particularly in the first few years).
  • Hospice referral is important early in the disease course for patients with metastatic disease because their survival is typically 6 months or less.
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Deterrence/Prevention

  • Because a calcified (porcelain) gallbladder has up to a 25% incidence of associated gallbladder cancer, this is an indication for a cholecystectomy even in an asymptomatic patient.
  • A small percentage (< 10%) of patients with gallbladder polyps are found to have underlying gallbladder cancer. The risk increases with age and the size of the polyp. A cholecystectomy should be considered if a gallbladder polyp greater than 1 cm in size is found in a patient older than 50 years.
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Prognosis

Survival at 5 years is correlated with stage of disease at presentation. Only 10-20% of patients present with localized disease. The remainder present with regional or distant spread. According to the SEER registry on gallbladder cancer, the 5-year survival rates for localized, regional, and distant disease are approximately 40%, 15%, and less than 10%, respectively. The median survival for advanced disease is short (2-4 mo).

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Contributor Information and Disclosures
Author

Mary Denshaw-Burke, MD, FACP  Clinical Assistant Professor of Medicine, Jefferson Medical College of Thomas Jefferson University; Clinical Assistant Professor, Affiliated Clinical Faculty of the Lankenau Institute for Medical Research; Program Director of Hematology/Oncology Fellowship, Education Coordinator for Oncology, Lankenau Medical Center

Mary Denshaw-Burke, MD, FACP is a member of the following medical societies: American College of Physicians and Pennsylvania Medical Society

Disclosure: Novartis Pharmaceuticals Honoraria Speaking and teaching

Coauthor(s)

Jessica B Katz, MD, PhD, FACP  Associate Director, Discovery Medicine Clinical Pharmacology, Oncology Division, Bristol Myers Squibb

Jessica B Katz, MD, PhD, FACP is a member of the following medical societies: American College of Physicians and Phi Beta Kappa

Disclosure: BMS Salary Employment

Andrew Scott Kennedy, MD  Co-Medical Director, Wake Radiology Oncology

Andrew Scott Kennedy, MD is a member of the following medical societies: Alpha Omega Alpha, American Association for Cancer Research, American Hepato-Pancreato-Biliary Association, American Society for Therapeutic Radiology and Oncology, American Society of Clinical Oncology, and Radiological Society of North America

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael Perry, MD, MS, MACP  Nellie B Smith Chair of Oncology Emeritus, Director, Division of Hematology and Medical Oncology, Deputy Director, Ellis Fischel Cancer Center, University of Missouri-Columbia School of Medicine

Michael Perry, MD, MS, MACP is a member of the following medical societies: Alpha Omega Alpha, American Association for Cancer Research, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Medical Association, American Society of Clinical Oncology, American Society of Hematology, International Association for the Study of Lung Cancer, and Missouri State Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Benjamin Movsas, MD  Vice-Chairman, Department of Radiation Oncology, Fox Chase Cancer Center

Benjamin Movsas, MD is a member of the following medical societies: American College of Radiology, American Radium Society, and American Society for Therapeutic Radiology and Oncology

Disclosure: Nothing to disclose.

Rajalaxmi McKenna, MD, FACP  Southwest Medical Consultants, SC, Department of Medicine, Good Samaritan Hospital, Advocate Health Systems

Rajalaxmi McKenna, MD, FACP is a member of the following medical societies: American Society of Clinical Oncology, American Society of Hematology, and International Society on Thrombosis and Haemostasis

Disclosure: Nothing to disclose.

Chief Editor

Jules E Harris, MD  Clinical Professor of Medicine, Section of Hematology/Oncology, University of Arizona College of Medicine, Arizona Cancer Center

Jules E Harris, MD is a member of the following medical societies: American Association for Cancer Research, American Association for the Advancement of Science, American Association of Immunologists, American Society of Hematology, and Central Society for Clinical Research

Disclosure: GlobeImmune Salary Consulting

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