RESEARCH COMMUNICATION Gallbladder Cancer: a Subtype of Biliary Tract Cancer Which is a Current Challenge in China

Biliary tract carcinomas (BTCs) including cholangiocarcinoma and gallbladder cancer arise from the bile duct epithelia (Figure 1). Prominent risk factors of BTC include cholelithiasis, chronic inflammation, congenital abnormalities of the biliary tree and genetic predisposition (Aljiffry et al., 2009; Onori et al., 2010). The relative low incidence of BTCs appeared to ascent in the past decades, among which, cholangiocarcinoma (CC) became the second most common primary hepatobiliary malignancy. Although the incidence of intrahepatic cholangiocarcinoma (ICC), which is a subtype of CC, was increasing worldwide (especially in Asia), the extrahepatic one (ECC) incidence was somewhat stable or even declining in some region (Sun et al., 2011). Gallbladder carcinoma (GBC) was also considered to be a highly increasing hepatobiliary malignant disease in Eastern-Asia. Surgical resection was considered the curative treatment option for all categories of BTCs. Unfortunately, most BTCs were diagnosed at advanced stages with the unresectable tumor (Patel et al., 2002), leading to a poor survival outcome. The postoperative 5-year overall survival rate was reported to be 5 to 40%, with the overall survival time and recurrence-free survival time to be 2733 and 9-27 months, respectively (Wolpin