{"entity":{"id":"paper-roa-gallbladder-preneoplastic-lesions-jso-2006","kind":"paper","name":"Preneoplastic lesions in gallbladder cancer","aka":[],"tldr":"Gallbladder cancer mostly grows from flat dysplasia rather than from polyps: dysplasia and carcinoma in situ sit next to four in five cancers, adenomas are rare, and the age gap between dysplasia and invasive cancer suggests about ten years of progression.","summary":"A review of the epithelial lesions involved in gallbladder carcinogenesis, dysplasia and adenomas, which represent two biologically distinct models. Dysplasia progresses to carcinoma in situ and then invasion; over 80% of invasive gallbladder cancers have areas adjacent to carcinoma in situ and epithelial dysplasia. Adenomas are uncommon (0.14% of cholecystectomies) and adenomatous remnants are found next to fewer than 3% of early carcinomas, suggesting the limited importance of that pathway.\n\nEpithelial dysplasia unassociated with cancer is seen in about 1% of cholecystectomies for symptomatic stones. Metaplasia, dysplasia and carcinoma in situ are present in the mucosa adjacent to cancer in 66%, 81.3% and 69% of cases. The average ages of patients with isolated dysplasia (51.9 years), early carcinoma (56.8) and advanced carcinoma (62.9) form a gradient that suggests progression over roughly 10 years.","asOf":"2026-09-24","links":[{"label":"Roa et al., J Surg Oncol 2006: preneoplastic lesions in gallbladder cancer","url":"https://doi.org/10.1002/jso.20527"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/16724345/"}],"tags":[],"related":[],"cancers":["gallbladder"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["dysplasia","metaplasia-dysplasia-carcinoma-sequence","intracholecystic-papillary-tubular-neoplasm"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["journal-of-surgical-oncology"],"dependsOn":[],"notes":[],"journal":"Journal of Surgical Oncology","year":2006,"doi":"10.1002/jso.20527","pmid":"16724345","authors":"Roa I, de Aretxabala X, Araya JC, Roa J.","paperType":"review","findings":["Metaplasia, dysplasia and carcinoma in situ adjacent to cancer in 66%, 81.3% and 69% of cases.","Adenomas in 0.14% of cholecystectomies; adenomatous remnants next to fewer than 3% of early carcinomas.","Mean ages 51.9 (dysplasia), 56.8 (early carcinoma), 62.9 (advanced carcinoma): about a 10-year sequence."],"whatItMeans":"The morphological argument that gallbladder cancer is a flat-dysplasia disease, which is why it is invisible on imaging until late and why prevention rests on removing the diseased gallbladder rather than on polyp surveillance alone.","caveats":["Chilean cholecystectomy series; the adenoma fraction may differ elsewhere.","Age gradients estimate, rather than observe, progression time."],"changedPractice":false},"route":"/key-papers/paper-roa-gallbladder-preneoplastic-lesions-jso-2006/","neighbours":{"cancer":[{"id":"gallbladder","kind":"cancer","name":"Gallbladder cancer","route":"/cancers/gallbladder/"}],"term":[{"id":"dysplasia","kind":"term","name":"Dysplasia (pre-cancerous change)","route":"/terms/dysplasia/"},{"id":"intracholecystic-papillary-tubular-neoplasm","kind":"term","name":"Intracholecystic papillary-tubular neoplasm (ICPN)","route":"/terms/intracholecystic-papillary-tubular-neoplasm/"},{"id":"metaplasia-dysplasia-carcinoma-sequence","kind":"term","name":"Metaplasia, dysplasia, carcinoma in situ: the flat route to gallbladder cancer","route":"/terms/metaplasia-dysplasia-carcinoma-sequence/"}],"journal":[{"id":"journal-of-surgical-oncology","kind":"journal","name":"Journal of surgical oncology","route":"/journals/journal-of-surgical-oncology/"}]}}