Rare in the Western world, gallbladder cancer is a lethal cancer more commonly seen in Eastern countries and some countries in South America. Surgery has the potential to cure most cases of early-stage disease and prolong survival in some advanced cases, whereas chemotherapy offers less benefit and is limited to fluoropyrimidine- and gemcitabine-based combinations with some recent introductions of targeted therapies, such as erlotinib and bevacizumab.
Most patients are diagnosed when they undergo gallbladder surgery for a presumed benign diagnosis, with the cancer found incidentally on the postoperative histopathology report. The best option for these, and virtually all, patients is to be referred to a high-volume center of excellence. A second resection is often advised in patients with incidentally detected gallbladder cancer, largely in an effort to eradicate residual disease, which is common and can range from 40% to 70% of patients depending on T stage.
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