The Surgical Strategy for Treating T1 Gallbladder Cancer

Lee, Seung Eun; Jang, Jin Young; Kim, Sun Whe

Abstract

Because T1 Gallbladder cancer (GB) has shown a better prognosis than advanced GB cancer, some authors have considered it proper to perform only cholecystectomy. Yet there has been controversy regarding the optimum management owing to the lack of evidence. Thus, retrospectively evaluating the therapeutic effect of each of these surgical procedure is essential to establish the appropriate surgical procedures for treating T1a & T1b GB cancer. In this study, we systematically reviewed 33 articles on T1a & T1b GB cancer. In most of the series, the treatment of choice for patients with T1a was a simple cholecystectomy with a 5-year survival of 100%. For T1b GB cancer, there was no definite evidence to support the superiority of extended cholecystectomy as opposed to simple cholecystectomy. However, considering the low recurrence rate after extended cholecystectomy, it is recommendable for patients who have a low preoperative risk to undergo extended cholecystectomy. Since lymph node metastasis occurs in about 8% of patients with T1b GB cancer, lymph node dissection is needed for the purposes of treatment and staging.