{"entity":{"id":"gallbladder-adenocarcinoma","kind":"cancer","name":"Gallbladder adenocarcinoma","aka":["Adenocarcinoma of the gallbladder","Non-papillary adenocarcinoma of the gallbladder","Pancreatobiliary-type gallbladder adenocarcinoma"],"tldr":"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.","summary":"Adenocarcinoma of the gallbladder arises from the glandular epithelium of the mucosa, usually on a background of chronic cholecystitis and gallstones, and in the WHO classification (5th edition, 2019) is subdivided by pattern: the common biliary (pancreatobiliary) type, intestinal type, gastric foveolar, mucinous, signet-ring, clear cell, hepatoid and other rare patterns (Nagtegaal 2020; Roa 2022). Cancer Research UK uses a simpler split into non-papillary, papillary and mucinous adenocarcinoma. In the largest pathology series conventional pancreatobiliary-type adenocarcinomas had a female to male ratio of 3.9 and a mean size of 2.9 cm (Dursun 2012, in which they were the comparator for mucinous carcinoma). Grade (1 well, 2 moderate, 3 poorly differentiated), depth of invasion (T category), the T2a or T2b side, lymphovascular and perineural invasion, node number and the cystic duct margin are the pathological findings that drive treatment (CRUK stages and grades; Shindoh 2015; Aloia 2015).\n\nBecause adenocarcinoma is the type every guideline and trial assumes, its management is the main page's: simple cholecystectomy suffices for Tis and T1a, radical cholecystectomy from T1b, adjuvant capecitabine after resection (BILCAP), and gemcitabine and cisplatin with durvalumab or pembrolizumab for advanced disease (TOPAZ-1, KEYNOTE-966), with HER2-directed therapy for the HER2-positive subset. The mucinous, papillary, adenosquamous and neuroendocrine pages describe how the rarer types differ.","asOf":"2026-09-24","wikipedia":"https://en.wikipedia.org/wiki/Gallbladder_cancer","links":[{"label":"CRUK: types of gallbladder cancer","url":"https://www.cancerresearchuk.org/about-cancer/gallbladder-cancer/types"},{"label":"Nagtegaal, Histopathology 2020: the 2019 WHO classification of tumours of the digestive system","url":"https://doi.org/10.1111/his.13975"},{"label":"Roa, Nature Reviews Disease Primers 2022: gallbladder cancer","url":"https://doi.org/10.1038/s41572-022-00398-y"},{"label":"Dursun, Arch Pathol Lab Med 2012: mucinous carcinomas of the gallbladder, 15 of 606 carcinomas","url":"https://doi.org/10.5858/arpa.2011-0447-oa"},{"label":"Louis, Cancer Causes Control 2025: gallbladder adenocarcinoma and neuroendocrine carcinoma in the National Cancer Database","url":"https://doi.org/10.1007/s10552-025-01967-8"},{"label":"CRUK: stages and grades of gallbladder cancer","url":"https://www.cancerresearchuk.org/about-cancer/gallbladder-cancer/stages-and-grades"}],"tags":["gallbladder","biliary","subtype-page"],"related":["gallbladder","gallbladder-papillary-carcinoma","gallbladder-mucinous-carcinoma","gallbladder-adenosquamous-squamous-carcinoma","cholangiocarcinoma"],"cancers":[],"sections":[],"technologies":[],"targets":["her2"],"drugs":["gemcitabine-cisplatin","durvalumab","pembrolizumab","capecitabine","zanidatamab"],"companies":[],"institutions":[],"pathways":[],"terms":["tumour-grade","t2a-versus-t2b","cystic-duct-margin","radical-cholecystectomy"],"trials":["bilcap","topaz-1","keynote-966"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"group":"gastrointestinal","burden":"About 90 percent of gallbladder cancers (Cancer Research UK); 96.7 percent of gallbladder neoplasms recorded in the US National Cancer Database in 2011 to 2020 were adenocarcinomas when compared with neuroendocrine carcinomas (Louis 2025).","subtypes":["Biliary (pancreatobiliary) type gallbladder adenocarcinoma, the commonest","Intestinal-type gallbladder adenocarcinoma","Mucinous gallbladder adenocarcinoma (own page)","Papillary gallbladder carcinoma (own page)","Signet-ring, clear cell and hepatoid variants (rare)"],"biomarkers":["Grade 1 to 3","T category and T2a or T2b side","Node number (N1 one to three, N2 four or more)","Cystic duct margin","HER2, mismatch repair, BRAF V600E and NTRK (frequencies on the main gallbladder cancer page)"],"standardOfCare":[{"setting":"Resectable disease","approach":"Simple cholecystectomy for Tis and T1a; radical cholecystectomy with liver bed and portal lymphadenectomy from T1b; adjuvant capecitabine (BILCAP).","refs":["simple-cholecystectomy","radical-cholecystectomy","capecitabine","bilcap"]},{"setting":"Advanced disease","approach":"Gemcitabine and cisplatin with durvalumab or pembrolizumab; zanidatamab for HER2-positive disease after chemotherapy.","refs":["gemcitabine-cisplatin","durvalumab","pembrolizumab","zanidatamab"]}],"stateOfArt":[],"history":[],"pipeline":[],"openProblems":[],"parent":"gallbladder"},"route":"/cancers/gallbladder-adenocarcinoma/","neighbours":{"cancer":[{"id":"gallbladder-adenosquamous-squamous-carcinoma","kind":"cancer","name":"Adenosquamous and squamous carcinoma of the gallbladder","route":"/cancers/gallbladder-adenosquamous-squamous-carcinoma/"},{"id":"cholangiocarcinoma","kind":"cancer","name":"Biliary tract cancer (cholangiocarcinoma)","route":"/cancers/cholangiocarcinoma/"},{"id":"gallbladder-carcinoma-in-situ-and-dysplasia","kind":"cancer","name":"Carcinoma in situ and dysplasia of the gallbladder","route":"/cancers/gallbladder-carcinoma-in-situ-and-dysplasia/"},{"id":"gallbladder","kind":"cancer","name":"Gallbladder cancer","route":"/cancers/gallbladder/"},{"id":"incidental-gallbladder-cancer","kind":"cancer","name":"Incidental gallbladder cancer (found after cholecystectomy)","route":"/cancers/incidental-gallbladder-cancer/"},{"id":"gallbladder-mucinous-carcinoma","kind":"cancer","name":"Mucinous carcinoma of the gallbladder","route":"/cancers/gallbladder-mucinous-carcinoma/"},{"id":"gallbladder-neuroendocrine-carcinoma","kind":"cancer","name":"Neuroendocrine carcinoma of the gallbladder","route":"/cancers/gallbladder-neuroendocrine-carcinoma/"},{"id":"gallbladder-papillary-carcinoma","kind":"cancer","name":"Papillary carcinoma of the gallbladder","route":"/cancers/gallbladder-papillary-carcinoma/"}],"target":[{"id":"her2","kind":"target","name":"HER2","route":"/targets/her2/"}],"drug":[{"id":"capecitabine","kind":"drug","name":"Capecitabine","route":"/drugs/capecitabine/"},{"id":"durvalumab","kind":"drug","name":"Durvalumab","route":"/drugs/durvalumab/"},{"id":"gemcitabine-cisplatin","kind":"drug","name":"Gemcitabine + cisplatin","route":"/drugs/gemcitabine-cisplatin/"},{"id":"pembrolizumab","kind":"drug","name":"Pembrolizumab","route":"/drugs/pembrolizumab/"},{"id":"zanidatamab","kind":"drug","name":"Zanidatamab","route":"/drugs/zanidatamab/"}],"term":[{"id":"cystic-duct-margin","kind":"term","name":"Cystic duct margin","route":"/terms/cystic-duct-margin/"},{"id":"tumour-grade","kind":"term","name":"Grade","route":"/terms/tumour-grade/"},{"id":"radical-cholecystectomy","kind":"term","name":"Radical (extended) cholecystectomy","route":"/terms/radical-cholecystectomy/"},{"id":"segment-ivb-v-resection","kind":"term","name":"Segment IVb and V liver resection (versus wedge resection)","route":"/terms/segment-ivb-v-resection/"},{"id":"simple-cholecystectomy","kind":"term","name":"Simple cholecystectomy","route":"/terms/simple-cholecystectomy/"},{"id":"t2a-versus-t2b","kind":"term","name":"T2a versus T2b gallbladder cancer (peritoneal side versus hepatic side)","route":"/terms/t2a-versus-t2b/"}],"trial":[{"id":"bilcap","kind":"trial","name":"BILCAP","route":"/trials/bilcap/"},{"id":"keynote-966","kind":"trial","name":"KEYNOTE-966","route":"/trials/keynote-966/"},{"id":"topaz-1","kind":"trial","name":"TOPAZ-1","route":"/trials/topaz-1/"}]}}