Makdissi FF, Kawakami LE, Pereira MA, Kruguer JAP, Marques GF, Coelho FF, Jukemura J, Herman P. Gallbladder carcinoma in Brazil: Clinicopathological profile and survival outcomes from a high-volume cancer center. World J Gastroenterol 2026; 32(7): 113845 [DOI: 10.3748/wjg.v32.i7.113845]
Corresponding Author of This Article
Fabio Ferrari Makdissi, PhD, Department of Gastroenterology, Instituto do Cancer, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Av Dr Arnaldo, 251, São Paulo 01246000, Brazil. fabio.makdissi@hc.fm.usp.br
Research Domain of This Article
Gastroenterology & Hepatology
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Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Feb 21, 2026 (publication date) through Feb 6, 2026
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World Journal of Gastroenterology
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1007-9327
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Makdissi FF, Kawakami LE, Pereira MA, Kruguer JAP, Marques GF, Coelho FF, Jukemura J, Herman P. Gallbladder carcinoma in Brazil: Clinicopathological profile and survival outcomes from a high-volume cancer center. World J Gastroenterol 2026; 32(7): 113845 [DOI: 10.3748/wjg.v32.i7.113845]
World J Gastroenterol. Feb 21, 2026; 32(7): 113845 Published online Feb 21, 2026. doi: 10.3748/wjg.v32.i7.113845
Gallbladder carcinoma in Brazil: Clinicopathological profile and survival outcomes from a high-volume cancer center
Fabio Ferrari Makdissi, Lucas Eiki Kawakami, Marina Alessandra Pereira, Jaime Arthur Pirola Kruguer, Gilton Fonseca Marques, Fabricio Ferreira Coelho, José Jukemura, Paulo Herman
Fabio Ferrari Makdissi, Lucas Eiki Kawakami, Marina Alessandra Pereira, Jaime Arthur Pirola Kruguer, Department of Gastroenterology, Instituto do Cancer, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246000, Brazil
Gilton Fonseca Marques, Fabricio Ferreira Coelho, José Jukemura, Paulo Herman, Department of Gastroenterology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403900, Brazil
Author contributions: Makdissi FF and Kawakami LE collected the data; Makdissi FF designed the research study, performed the critical analysis, and wrote the manuscript; Kawakami LE and Pereira MA contributed to the manuscript writing; Pereira MA analyzed the data; Kruguer JAP, Marques GF, Coelho FF, Jukemura J, and Herman P performed the critical analysis and reviewed the manuscript. All authors read and approved the final manuscript.
Institutional review board statement: The study was approved by the Ethics Committee of Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, and registered online (https://plataformabrasil.saude.gov.br; CAAE: 90775625.0.0000.0068).
Informed consent statement: Informed consent was waived by the local Ethics Committee because of the retrospective nature of the study.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fabio Ferrari Makdissi, PhD, Department of Gastroenterology, Instituto do Cancer, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Av Dr Arnaldo, 251, São Paulo 01246000, Brazil. fabio.makdissi@hc.fm.usp.br
Received: September 5, 2025 Revised: October 25, 2025 Accepted: December 10, 2025 Published online: February 21, 2026 Processing time: 154 Days and 17 Hours
Abstract
BACKGROUND
Gallbladder cancer (GBC) is the most prevalent malignant tumor of the biliary tract and remains associated with poor survival outcomes due to its aggressive biological behavior and typically late diagnosis. Regional differences in incidence and outcomes emphasize the need for country-specific data. In Brazil such information remains scarce.
AIM
To evaluate the clinicopathological characteristics, therapeutic approaches, and survival outcomes of patients with GBC treated at a high-volume cancer center in Brazil.
METHODS
This retrospective study analyzed 364 patients with histologically confirmed gallbladder adenocarcinoma treated at a high-volume Brazilian cancer center from 2010 to 2024. Clinical, pathological, and treatment-related variables were analyzed. Patients were stratified into incidental GBC (IGBC) and non-IGBC groups.
RESULTS
The cohort was predominantly female (78.8%) with a mean age of 62.1 years. Most patients (72.3%) presented with stage IV disease. IGBC accounted for 54.1% of cases and showed significantly improved survival compared with non-IGBC [median overall survival (OS): 18 months vs 7 months; P < 0.001]. Radical surgery was performed in 13.5% of patients, achieving a 5-year OS of 57.5%. Independent predictors of worse OS included poor performance status [Eastern Cooperative Oncology Group > 2; hazard ratio (HR) = 1.91], advanced T stage (T3: HR = 4.38; T4: HR = 5.24), metastasis (M1; HR = 2.76), and non-IGBC diagnosis (HR = 1.35).
CONCLUSION
GBC in Brazil commonly presents at advanced stages, restricting curative options. IGBC is more prevalent and has better outcomes. Radical surgery confers the best prognosis but remains feasible in a minority of patients.
Core Tip: This retrospective study evaluated the clinicopathological characteristics, treatment strategies, and survival outcomes of patients with gallbladder carcinoma (GBC) treated at a high-volume cancer center in Brazil. Most patients presented with advanced stage disease, limiting curative options. Incidental GBC was more frequent than non-incidental cases and associated with significantly better survival. Radical surgery although feasible in a minority provided the best long-term outcomes. These findings highlighted the importance of early detection and timely referral to specialized hepatobiliary centers to improve prognosis in GBC.
