Kumar Shiyam, Masood Nehal, Shaikh Asim Jamal, Valimuhammad Azmina T, Haider Ghulam, Lal Amar, Niamatullah Najeeb
Liaqat National Hospital, Karachi, Pakistan.
Asian Pac J Cancer Prev. 2009 Jul-Sep;10(3):463-6.
Gallbladder cancer (GBC) is a common malignancy in our country; however, very limited data exist on this malignancy in Pakistan.
This is a retrospective analysis of all the admitted patients diagnosed with GBC or cholangiocarcinoma in between 1st January 1995 to 31st December 2007.
A total of 245 patients were admitted with diagnosis of GBC or cholangiocarcinoma. Sixty seven percent were females. Right hypochondrial pain (70.6%) and jaundice (49.8%) were the commonest symptoms, followed by nausea and vomiting (11.8%), weight loss (13%), fever (18.8%), anorexia (9.8%) and ascites (3.3%). Gallstones were seen in 132 (53.9%) patients. Pathological diagnosis was confirmed in 155 (63.2%) patients, adenocarcinoma (94.8%) being the predominant type. Metastasis was seen in 204 (83.3%) patients, with liver and abdominal lymph nodes being the frequent sites of metastasis. Most of the patients presented to the surgeons (42.9%) and gastroenterologists (35.9%) at their first visit. Only 89 (26.3%) patients were referred to medical oncologists and 42 (16.7%) of the patients actually received chemotherapy. The patients who received chemotherapy cisplatin and gemcitabine demonstrated partial responses (40%). Common bile duct stricture was seen in 78 patients and stenting was successful in 73 patients. Fourteen (5.7%) patients are alive to date, one is receiving chemotherapy, and another is alive with advanced disease while 10 patients had incidental diagnosis after surgery. Of all 53.9% of patients have died and 38% are lost to follow up.
Most of the patients with biliary cancers present late with advanced disease at our referral tertiary care hospital. Minority of the patients received chemotherapy and most of responses were observed with cisplatin and gemcitabine combination or capecitbine based therapy.
胆囊癌（GBC）在我国是一种常见的恶性肿瘤；然而，在巴基斯坦，关于这种恶性肿瘤的数据非常有限。
这是一项对1995年1月1日至2007年12月31日期间所有确诊为GBC或胆管癌的住院患者的回顾性分析。
共有245例患者被诊断为GBC或胆管癌而入院。其中67%为女性。最常见的症状是右季肋部疼痛（70.6%）和黄疸（49.8%），其次是恶心和呕吐（11.8%）、体重减轻（13%）、发热（18.8%）、厌食（9.8%）和腹水（3.3%）。132例（53.9%）患者有胆结石。155例（63.2%）患者确诊为病理诊断，其中腺癌（94.8%）为主要类型。204例（83.3%）患者出现转移，肝脏和腹部淋巴结是常见的转移部位。大多数患者首次就诊时是外科医生（42.9%）和胃肠病学家（35.9%）接诊。只有89例（26.3%）患者转诊至肿瘤内科医生处，42例（16.7%）患者实际接受了化疗。接受顺铂和吉西他滨化疗的患者显示部分缓解（40%）。78例患者出现胆总管狭窄，73例患者支架置入成功。14例（5.7%）患者至今仍存活，1例正在接受化疗，另1例晚期疾病存活，10例患者术后偶然诊断。在所有患者中，53.9%的患者死亡，38%失访。
在我们的三级转诊医院，大多数胆管癌患者就诊时已处于晚期。少数患者接受了化疗，大多数缓解是在顺铂和吉西他滨联合或基于卡培他滨的治疗中观察到的。
