Gut Liver.  2016 Jan;10(1):140-146. 10.5009/gnl15080.

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

• Jung W
• Jang JY
• Kang MJ
• Chang YR
• Shin YC
• Chang J
• Kim SW

• KMID: 2382355
• DOI: http://doi.org/10.5009/gnl15080

Abstract

BACKGROUND/AIMS
Extended 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.
METHODS
Clinicopathological characteristics, extent of resection, survival rates, and recurrence patterns were retrospectively analyzed in 88 patients with pathologically confirmed T2 gallbladder cancer.
RESULTS
The 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.
CONCLUSIONS
Extended 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.

Keyword

Gallbladder neoplasms; Cholecystectomy; Survival; Recurrence; Tumor location

MeSH Terms

Adult
Aged
Aged, 80 and over
Cholecystectomy/*methods/mortality
Disease-Free Survival
Female
Gallbladder/pathology
*Gallbladder Neoplasms/mortality/pathology/surgery
Humans
Lymph Node Excision
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Recurrence, Local/*etiology/pathology
Neoplasm Staging
Retrospective Studies
Risk Factors
Survival Rate
Treatment Outcome