Trends in incidence and management of gallbladder carcinoma - A population-based study in France

BACKGROUND. Little is known, at a population level, about the incidence and management of gallbladder carcinoma. The objective of this study was to de termine trends in incidence, treatment, stage at diagnosis, and prognosis o f gallbladder carcinoma in a well defined population. METHODS. A series of 484 patients diagnosed over a 20-year period (1976-199 5) in a French well defined population was used. Incidence rates were calcu lated by gender, age groups, and 5-year periods. Prognosis was determined u sing crude and relative survival rates. A multivariate relative survival an alysis was performed. RESULTS, Age-standardized incidence rates were 0.8 per 100,000 inhabitants for men and 1.5 per 100,000 inhabitants for women. There were no significan t time trends in incidence in both genders. The proportion of cases resecte d for cure increased from 18.1% (1976-1980) to 42.4% (1991-1995) (P < 0.001 ) as well as the proportion of cases limited to the gallbladder wall, respe ctively from 15.7% to 27.8% (P < 0.001). Relative survival rates were 16.6% at 1 year and 6.2% at 5 years. Age, stage at diagnosis, and period of diag nosis significantly influenced the prognosis of gallbladder carcinoma. The 5-year relative survival rate rose from 2.7% (1976-1985) to 10.2% (1986-199 5). The multivariate analysis showed that age and stage at diagnosis were i ndependent prognostic factors. CONCLUSIONS. This study demonstrated that gallbladder carcinoma incidence i s stable in France and that substantial advances in its management have bee n achieved, but there is evidence that further improvements are necessary t o increase survival. (C) 2000 American Cancer Society.