CLINICAL EPIDEMIOLOGIC CHARACTERISTICS OF 430 CASES OF GALLBLADDER CANCER

Objective. To make clear the incidence, clinical characteristics and p ossible regional difference of gallbladder cancer in China. Methods. A total of 430 cases of gallbladder cancer from 28 hospitals between 19 86-1996 were reviewed, according to a standard protocol called ''the c linical epidemiological list of gallbladder cancer''. Results The inci dence of gallbladder cancer was higher in the females than in the male s. There was significant difference in the incidence between the north and south of China, and between the mountain area and flatlands. Gall bladder cancer accounted for 1.6% of bile tract disease in the same pe riod. Gallstones were found in about 50% of the cases of gallbladder c ancer. The clinical symptoms included abdominal pain, ictus, etc. The major pathohistologic type was adenocarcinoma, and 58% of tumors were localized in the whole gallbladder. Metastasis occurred mainly along t he biliary tract or directly to the bed of gallbladder and liver. Ultr asonography and CT were useful to diagnosis. The positive imaging diag nostic rate was higher in the first 5 years (1986-1990) than in the la st 5 years (1991-1996, P < 0.05). The rate of operative resection was 100% for stage I and II disease, 75% for stage III and IV, and signifi cantly lower for stage V (P < 0.05). The 3-year survival rate in patie nts with stage I or II disease was significantly higher than that in t hose with terminal cancer (P < 0.05). Conclusions. There is specific p opulational, time and regional difference in the distribution of gallb ladder cancer. Ultrasonography and CT are the most important diagnosti c methods. Early diagnosis and early radical resection are the key to increasing the 5-year survival rate.