biliary

Adenosquamous carcinoma is a gallbladder cancer that mixes gland-forming and squamous (skin-like) cancer cells; pure squamous carcinoma is rarer still. These tumours are larger and more advanced when found and do worse than ordinary adenocarcinoma, but they are treated in the same way because no trial has studied them separately.

The UK's only charity dedicated to cholangiocarcinoma and the other biliary tract cancers: patient information, a list of UK centres with expertise, research grants, an annual conference and a nurse study day.

Oncologist who led REACH-2, the first positive biomarker-selected trial in liver cancer, which established ramucirumab for patients with a high alpha-fetoprotein level.

Oncologist who was lead author of ABC-06, the first randomised trial to show that second-line chemotherapy helps people with advanced bile duct cancer.

A birth variation in which the bile duct and pancreatic duct join outside the wall of the bowel, so pancreatic juice flows back up into the bile ducts and gallbladder and irritates their lining for life. It carries a high risk of gallbladder cancer, and removing the gallbladder is advised once it is found.

Dysplasia means the cells lining the gallbladder have become abnormal but have not invaded; carcinoma in situ (stage 0) is the most abnormal form, with cancer cells still confined to the lining. Both are found by the pathologist after a gallbladder is removed and are cured by that removal when the margin is clear. Cancer Research UK notes some doctors do not regard stage 0 as a true cancer.

Cystic duct carcinoma is a bile duct cancer arising in the short tube that joins the gallbladder to the main bile duct. It is staged as a gallbladder cancer under the AJCC system, and behaves better when it stays inside the duct than when it grows beyond it. It is so rare that its treatment borrows from gallbladder and bile duct cancer.

The cut end of the short duct that joined the gallbladder to the main bile duct, examined by the pathologist after a gallbladder is removed. If cancer cells reach this edge, part of the main bile duct usually has to be removed at a second operation; if it is clear, the bile duct can be left alone.

Adenocarcinoma is the usual form of gallbladder cancer, about nine in ten cases, starting in the mucus-making gland cells of the lining. Everything on the main gallbladder cancer page (causes, staging, surgery, chemotherapy with immunotherapy) is written about this type unless it says otherwise.

Gallbladder cancer starts in the small bile-storing sac under the liver and is one of the biliary tract cancers. Most cases are found late, or by chance when a gallbladder is removed for gallstones. It is rare in the UK, with about 1,300 cases a year, and much commoner in Chile, Bolivia and northern India. Found early, an operation can cure it.

Gallbladder cancer is usually found by accident when a gallbladder is removed for stones, and for most of its history the only treatment was a bigger operation. This roadmap follows the disease from the first cholecystectomy in 1882, through staging by depth and the borrowed chemotherapy standards of 2010 and 2019, to immunotherapy and HER2 drugs, and lists the trial readouts to watch to 2030.

A small growth on the inside wall of the gallbladder, usually spotted by chance on an ultrasound scan. Most are harmless cholesterol deposits; the risk of cancer rises with size, so polyps of 10 mm or more are removed with the gallbladder and smaller ones are watched or left alone according to set rules.

Led HIMALAYA and ClarIDHy, which gave liver cancer a dual-immunotherapy option and biliary cancer its first targeted drug.

Liver surgeon at Aintree who co-wrote the BSG cholangiocarcinoma guideline and is a co-author of the UK-wide CAPBIL studies of gallbladder cancer surgery; a past president of the British Association of Surgical Oncology.

Incidental gallbladder cancer is cancer the pathologist finds in a gallbladder removed for gallstones or inflammation, when nobody suspected it. It is the commonest way this cancer is found early enough to cure. Whether a second operation is needed depends on how deep the tumour went: none for the earliest layers, a radical operation at a specialist centre for T1b or deeper.

Senior author of the UK's two standard-setting biliary trials, ABC-02 and BILCAP, chief investigator of ABC-06, and UK lead of the first-line precision medicine trial SAFIR-ABC10.

British surgeon who led BILCAP, the trial that made six months of capecitabine the standard after surgery for bile duct and gallbladder cancer.

Led ABC-02, which made gemcitabine plus cisplatin the global standard for biliary cancer, and co-led TOPAZ-1.

Led the futibatinib trial and defined how FGFR2-driven bile duct cancers become resistant to targeted drugs.

Leads biliary tract cancer trials at The Christie, the Manchester centre behind the ABC trial series, and is a member of the international biliary trial collaborations.

Mucinous carcinoma is a rare gallbladder cancer in which the cancer cells sit in pools of mucus that make up more than half the tumour. It affects men almost as often as women, is larger than usual at diagnosis, and often presents like an acute gallbladder attack. It is staged and treated like other gallbladder adenocarcinomas.

Neuroendocrine carcinoma is a rare, fast-growing form of gallbladder cancer made of small cell or large cell hormone-type cells, often mixed with ordinary adenocarcinoma. It is usually advanced when found and median survival in the largest series was six to seven months. It is treated like other high-grade neuroendocrine carcinomas rather than like gallbladder adenocarcinoma.

Papillary carcinoma is a gallbladder cancer that grows as finger-like fronds into the cavity rather than burrowing into the wall. Cancer Research UK notes it is less likely to spread to the liver and lymph nodes and tends to have a better outlook. Its polypoid precursor, the intracholecystic papillary neoplasm, is often removed before it invades.

A gallbladder whose wall has turned hard and chalky with calcium after years of inflammation, seen on a scan or X-ray. It was long thought to lead to cancer in many cases; newer studies find the risk is real but much smaller, so whether to remove a symptom-free porcelain gallbladder is now a judgement call.

Cancer growing in the small keyhole wounds of a laparoscopic operation, seeded when a gallbladder containing an unsuspected cancer was pulled out through them. It was once seen in up to one in five incidental gallbladder cancers; it is now about one in ten, and cutting out the old port sites at the second operation does not improve survival.

The cancer operation for gallbladder cancer: the gallbladder (if still present) is removed together with a rim of the liver it sits against and the lymph nodes along the bile duct and liver blood vessels. After an incidental cancer it is done as a second operation about four to eight weeks after the first.

San Francisco oncologist who was lead author of KEYNOTE-966, which showed that adding pembrolizumab to gemcitabine and cisplatin helps people with advanced bile duct cancer live longer.

Tiny pouches where the gallbladder lining pushes down into the muscle wall, common in gallbladders damaged by stones and inflammation. They matter in cancer because an early tumour that tracks down into these pouches behaves worse than one that stays on the surface, and mucus trapped in them can be mistaken for cancer under the microscope.

Two ways of removing the piece of liver the gallbladder sits on during a gallbladder cancer operation: a wedge of about two centimetres around the gallbladder bed, or the whole of the two anatomical liver segments (IVb and V) that touch it. The larger operation clears more tissue but carries more complications, and the evidence does not clearly favour either.

Hepatologist who documented the rise of cholangiocarcinoma in the UK and senior author of the 2023 British Society of Gastroenterology guideline that sets out how NHS teams should diagnose and manage it.

The standard operation to remove the gallbladder, almost always by keyhole surgery for gallstones. When a cancer is found in the removed gallbladder it is also the first, and for the earliest tumours the only, cancer operation.

Two labels for a gallbladder cancer that has grown through the muscle layer but is still inside the gallbladder. T2a sits on the free side facing the abdominal cavity; T2b sits on the side pressed against the liver, spreads to nodes and vessels more often and roughly doubles the risk of dying, so the surgeon removes more liver for it.