Ann Surg Treat Res.  2018 Mar;94(3):135-141. 10.4174/astr.2018.94.3.135.

The optimal surgical resection approach for T2 gallbladder carcinoma: evaluating the role of surgical extent according to the tumor location

Affiliations
  • 1Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea. kjkang@dsmc.or.kr
  • 2Department of Surgery, Andong Medical Group Hospital, Andong, Korea.
  • 3Department of Radiology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.

Abstract

PURPOSE
The clinical behavior of T2 gallbladder cancer varies among patients. The aims of this study were to identify prognostic factors for survival and recurrence, and to determine the optimal surgical strategy for T2 gallbladder cancer.
METHODS
We conducted a retrospective analysis of 78 patients with T2 gallbladder cancer who underwent surgical resection for gallbladder cancer.
RESULTS
Twenty-eight patients (35.9%) underwent simple cholecystectomy and 50 (64.1%) underwent extended cholecystectomy. Among 56 patients without LN metastasis (n = 20) or unknown LN status (no LN dissection, n = 36), the 5-year disease-free survival rates were 81.6%, and 69.8% (P = 0.080). In an analysis according to tumor location, patients with tumors located on the hepatic side (n = 36) had a higher recurrence rate than patients with tumors located on the peritoneal side only (n = 35) (P = 0.043). On multivariate analysis, R1 resection and lymph node metastasis were significant, independent prognostic factors for poor disease-free and overall survival.
CONCLUSION
R0 resection and LN dissection are an appropriate curative surgical strategy in patients with T2 gallbladder cancer. Tumors located on the hepatic side show worse prognosis than tumors located on the peritoneal side only, hepatic resection should be considered.

Keyword

Gallbladder neoplasms; Surgery

MeSH Terms

Cholecystectomy
Disease-Free Survival
Gallbladder Neoplasms
Gallbladder*
Humans
Lymph Nodes
Multivariate Analysis
Neoplasm Metastasis
Prognosis
Recurrence
Retrospective Studies
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