Effects of Surgical Methods and Tumor Location on Survival and Recurrence Patterns after Curative Resection in Patients with T2 Gallbladder Cancer

Abstract

Background/AimsExtended cholecystectomy is generally recommended for patients with T2 gallbladder cancer. However, few studies have assessed the extent of resection relative to T2 gallbladder tumor location. This study analyzed the effects of surgical methods and tumor location on survival outcomes and tumor recurrence in patients with T2 gallbladder cancer.MethodsClinicopathological characteristics, extent of resection, survival rates, and recurrence patterns were retrospectively analyzed in 88 patients with pathologically confirmed T2 gallbladder cancer.ResultsThe 5-year disease-free survival rate was 65.0%. Multivariate analysis showed that lymph node metastasis was the only independent risk factor for poor 5-year disease-free survival rate. Survival outcomes were not associated with tumor location. Survival tended to be better in patients who underwent extended cholecystectomy than in those who underwent simple cholecystectomy. Recurrence rate was not affected by surgical method or tumor location. Systemic recurrence was more frequent than local recurrence without distant recurrence. Gallbladder bed recurrence and liver recurrence were relatively rare, occurring only in patients with liver side tumors.ConclusionsExtended cholecystectomy is the most appropriate treatment for T2 gallbladder cancer. However, simple cholecystectomy with regional lymph node dissection may be appropriate for patients with serosal side tumors.

Extended cholecystectomy in gallbladder cancer: survival and surgical results in two time periods

“…Lymph node involvement generally has a constant pattern: initially those located in the cystic duct remnant, then in the chole-docoduodenal region and finally the paraaortic lymph nodes via the retro pancreatic lymph nodes. 9,13 The number of resected lymph nodes in this study (5.5 in average) was similar to that described in the literature. The range was variable (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14), which was to be expected due to anatomical variations in the hepatic pedicle that make the dissection more complex.…”

“…In relation to morbidity, several studies show similar results with the presence of surgical site infections, pneumonias or urinary tract infections. 9,[12][13][14] Regarding hospital stay, it has been described that patients who undergo a laparoscopic EC have a shorter hospital stay and less postoperative pain than those who undergo open surgery, advantages associated with the laparoscopic surgery itself. 11,15,16 In terms of the possible role of the EC in patients in early stages of the disease (T1a tumors), in patients with Rokitansky-Aschoff (RA) sinus involvement, there is no categorical consensus as to whether or not they benefit from the EC.…”

A retrospective analysis of patients with gallbladder cancer: surgical treatment and survival according to tumor stage

“…In our series, regional lymphadenectomy was performed in all patients undergoing an extended cholecystectomy. Furthermore, patients without lymph node involvement (N0) have higher survival rates (p < 0.05) compared to subjects with node involvement (N+); at least 4-5 lymph nodes should be analyzed in order to rule out nodal involvement (26).…”

Updated Management of Malignant Biliary Tract Tumors: An Illustrative Review

“…The role of extended regional lymphadenectomy on clinical outcome remains equivocal (27). Five-year disease-free survival rates after GBA resection have been reported to be as high as 65% (28).…”