# Carcinoma of the gallbladder: staging, treatment, and prognosis

Source: https://onco.cc/key-papers/paper-nevin-gallbladder-carcinoma-staging-cancer-1976/  
OnCo record `paper-nevin-gallbladder-carcinoma-staging-cancer-1976` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The 1976 paper that first staged gallbladder cancer by how deeply it had grown through the wall, noting that almost every case had been found by chance during gallstone surgery.

## Summary

Sixty-six cases from two Virginia hospitals were staged by depth of invasion and spread and graded histologically, and survival was correlated with both; results agreed with 399 reported cases in the literature that could be staged by depth of invasion. The authors describe a simple method combining staging and histological grade applicable to every surgically removed gallbladder cancer. Essentially all carcinomas in the series were incidental findings at surgery for gallstones, which the authors suggest explains a relatively high proportion of superficial carcinomas cured by cholecystectomy.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Tags: gallbladder-evidence
- Journal: Cancer
- Year: 1976
- DOI: 10.1002/1097-0142(197601)37:1<141::AID-CNCR2820370121>3.0.CO;2-Y
- Authors: Nevin JE, Moran TJ, Kay S, King R.
- Findings: Depth of invasion correlated with survival in 66 cases and 399 literature cases.; Essentially all cases were incidental findings at surgery for gallstones.
- What it means: Depth of invasion has been the organising principle of gallbladder cancer staging ever since, through the TNM editions to the 2017 T2a/T2b split; and the observation that most cases are incidental was already true fifty years ago.
- Caveats: Small historical series.; Pre-TNM staging scheme, superseded.

## Sources

- Cancer 1976: https://doi.org/10.1002/1097-0142(197601)37:1<141::AID-CNCR2820370121>3.0.CO;2-Y
- PubMed: https://pubmed.ncbi.nlm.nih.gov/1247951/

## Connected records

- cancers: [Gallbladder cancer](https://onco.cc/cancers/gallbladder/), [Incidental gallbladder cancer (found after cholecystectomy)](https://onco.cc/cancers/incidental-gallbladder-cancer/)
- terms: [TNM staging](https://onco.cc/terms/tnm-staging/)
- roadmaps: [Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials](https://onco.cc/roadmaps/gallbladder-cancer-roadmap/)

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