J Korean Surg Soc.  2009 May;76(5):316-320. 10.4174/jkss.2009.76.5.316.

The Efficacy of Simple Cholecystectomy among Patients with T2 Gallbladder Cancer

• Lee JY
• Seo HI
• Sim MS

• KMID: 2096552
• DOI: http://doi.org/10.4174/jkss.2009.76.5.316

Abstract

PURPOSE
Stage-related treatment has been recommended for gallbladder cancer (GBC). When patients with T2 tumors undergo an extended cholecystectomy, the 5-year survival rates have been reported to be 64~100%. But when patients with T2 tumors undergo simple cholecystectomy, the 5-year survival rates have been reported to be only 20~40%. The question may rise as to which patients benefit from simple cholecystectomy among patients with T2 GBC. We investigated the survivals and the facts leading to death or recurrence after simple cholecystectomy for T2 GBC. METHODS: Between Mar. 2001 and Dec. 2007, 13 patients had refused second radical operation for T2 GBC incidentally discovered after simple cholecystectomy. Survival analyses were evaluated by clinopathological factors. RESULTS: The 1-, 3- and 4-year overall survival rates were 84.6%, 76.2% and 38.1% and 1- and 3-year disease-free survival rates were 69.2%, 51.3%. The factors affected survival rates were low serum albumin titer and R1 resection (Lymph node metastasis or cystic duct involvement in microscopic finding) (P<0.05). CONCLUSION: Simple cholecystectomy is not a curative method of T2 GBC, because it reveals lower 5-year survival rates compared to those of extended cholecystectomy or radical surgery. But in the case when the patient refuses reoperation or it is difficult to undergo reoperation because of severe underlying disease, simple cholecystectomy with normal albumin titer or the absence of lymph node metastasis and absence of cystic duct involvement in microscopic findings may help the long-term survivals after simple cholecystectomy.

Keyword

Gallbladder carcinoma; Simple cholecystectomy

MeSH Terms

Cholecystectomy
Cystic Duct
Disease-Free Survival
Gallbladder
Gallbladder Neoplasms
Humans
Lymph Nodes
Neoplasm Metastasis
Recurrence
Reoperation
Serum Albumin
Survival Rate
Serum Albumin

Figure

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  Fig. 1 Overall survival of 13 patients with T2 gallbladder cancer after simple cholecystectomy.

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  Fig. 2 Disease-free survival of 13 patients with T2 gallbladder cancer after simple cholecystectomy.

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