Gallbladder carcinoma in Brazil: Clinicopathological profile and survival outcomes from a high-volume cancer center

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: < 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.