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. 2016 Jan;10(1):140-6.
doi: 10.5009/gnl15080.

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

Woohyun Jung  1 , Jin-Young Jang  1 , Mee Joo Kang  1 , Ye Rim Chang  1 , Yong Chan Shin  1 , Jihoon Chang  1 , Sun-Whe Kim  1
Affiliations

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

Woohyun Jung et al. Gut Liver. 2016 Jan.

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.

Keywords: Cholecystectomy; Gallbladder neoplasms; Recurrence; Survival; Tumor location.

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Figures

Fig. 1
Fig. 1
Computed tomography scans of tumors on the serosal (A) and liver side (B).
Fig. 2
Fig. 2
Kaplan-Meier analysis of the 5-year disease-free survival (DFS) rate after curative resection in patients with T2 gallbladder cancer. (A) Total population. (B) Simple cholecystectomy. (C) Extended cholecystectomy. There was no significant difference in the 5-year disease-free survival rate between patients with liver-side and serosal-side tumors who underwent simple cholecystectomy (B) (43.7% vs 33.3%, p=0.578) or extended cholecystectomy (C) (70.1% vs 68.5%, p=0.986).
Fig. 3
Fig. 3
Recurrence pattern after curative resection in patients with T2 gallbladder (GB) cancer. LN, lymph node.
See this image and copyright information in PMC

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