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. 2018 May 30;33(28):e186.
doi: 10.3346/jkms.2018.33.e186. eCollection 2018 Jul 9.

Surgical Strategy for T2 Gallbladder Cancer: Nationwide Multicenter Survey in Korea

Seung Eun Lee  1 , Sun-Whe Kim  2 , Ho-Seong Han  2 , Woo Jung Lee  3 , Dong-Sup Yoon  3 , Baik-Hwan Cho  4 , In Seok Choi  5 , Hyun Jong Kim  6 , Soon-Chan Hong  7 , Sang-Mok Lee  8 , Dong Wook Choi  9 , Sang-Jae Park  10 , Hong-Jin Kim  11 , Jin-Young Jang  2 ; Korean Pancreas Surgery Club
Affiliations

Surgical Strategy for T2 Gallbladder Cancer: Nationwide Multicenter Survey in Korea

Seung Eun Lee et al. J Korean Med Sci. .

Abstract

Background: Although all guidelines suggest that T2 gallbladder (GB) cancer should be treated by extended cholecystectomy (ECx), high-level scientific evidence is lacking because there has been no randomized controlled trial on GB cancer.

Methods: A nationwide multicenter study between 2000 and 2009 from 14 university hospitals enrolled a total of 410 patients with T2 GB cancer. The clinicopathologic findings and long-term follow-up results were analyzed after consensus meeting of Korean Pancreas Surgery Club.

Results: The 5-year cumulative survival rate (5YSR) for the patients who underwent curative resection was 61.2%. ECx group showed significantly better 5YSR than simple cholecystectomy (SCx) group (65.4% vs. 54.0%, P = 0.016). For N0 patients, there was no significant difference in 5YSR between SCx and ECx groups (68.7% vs. 73.6%, P = 0.173). Systemic recurrence was more common than locoregional recurrence (78.5% vs. 21.5%). Elevation of cancer antigen 19-9 level preoperatively and lymph node (LN) metastasis were significantly poor prognostic factors in a multivariate analysis.

Conclusion: ECx including wedge resection of GB bed should be recommended for T2 GB cancer. Because systemic recurrence was more common and recurrence occurred more frequently in patients with LN metastasis, postoperative adjuvant therapy should be considered especially for the patients with LN metastasis.

Keywords: Carcinoma; Cholecystectomy; Extended; Gallbladder; Simple.

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Conflict of interest statement

Disclosure: The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
Survival curve of the curatively resected patients with T2 GB cancer compared between SCx and ECx. GB = gallbladder, SCx = simple cholecystectomy, ECx = extended cholecystectomy.
See this image and copyright information in PMC

References

    1. David SE, Mark A, Justin MM, Mihaela C, Crystal SD, Keith DE, et al. NCCN clinical practice guidelines in oncology (NCCN guidelines®) J Natl Compr Canc Netw. 2011;9(12):1358–1395. - PubMed
    1. Eckel F, Brunner T, Jelic S, ESMO Guidelines Working Group Biliary cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2011;22(Suppl 6):vi40–vi44. - PubMed
    1. Keller J, Wedel T, Seidl H, Kreis ME, Andresen V, Preiss JC, et al. S3 guideline of the German Society for Digestive and Metabolic Diseases (DGVS) and the German Society for Neurogastroenterology and Motility (DGNM) to the definition, pathophysiology, diagnosis and treatment of intestinal motility. Z Gastroenterol. 2011;49(3):374–390. - PubMed
    1. Kondo S, Takada T, Miyazaki M, Miyakawa S, Tsukada K, Nagino M, et al. Guidelines for the management of biliary tract and ampullary carcinomas: surgical treatment. J Hepatobiliary Pancreat Surg. 2008;15(1):41–54. - PMC - PubMed
    1. Downing SR, Cadogan KA, Ortega G, Oyetunji TA, Siram SM, Chang DC, et al. Early-stage gallbladder cancer in the Surveillance, Epidemiology, and End Results database: effect of extended surgical resection. Arch Surg. 2011;146(6):734–738. - PubMed