• Woohyung Lee, Chi-Young Jeong, Jae Yool Jang, KimYoung HoonYHDepartment of Surgery, Dong-A University Hospital, Dong-A University, College of Medicine, Busan, Republic of Korea., Young Hoon Roh, Kwan Woo Kim, Sung Hwa Kang, Myung Hee Yoon, Hyung Il Seo, Sung Pil Yun, Jeong-Ik Park, Bo-Hyun Jung, Dong Hoon Shin, Young Il Choi, Hyung Hwan Moon, Chong Woo Chu, Je Ho Ryu, Kwangho Yang, Young Mok Park, and Soon-Chan Hong.
• Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University, College of Medicine, Jinju, Republic of Korea.
• Surgery. 2017 Sep 1; 162 (3): 515-524.

BackgroundTumor location is a prognostic factor for survival in patients with T2 gallbladder cancer. However, the optimal extent of resection according to tumor location remains unclear.MethodsWe reviewed the records of 192 patients with T2 gallbladder cancer who underwent R0 or R1 resection at 6 institutions. Perioperative and oncologic outcomes were compared according to the extent of resection between hepatic-sided (n = 93) and peritoneal-sided (n = 99) tumors.ResultsAfter a median follow-up of 30 months, the 5-year overall survival (84.9% vs 71.8%, P = .048) and recurrence-free survival (74.6% vs 62.2%, P = .060) were greater in peritoneal-sided T2 patients than in hepatic-sided T2 patients. Among hepatic-sided T2 patients, the 5-year overall survival was greater in patients who underwent radical cholecystectomy including lymph node dissection with liver resection than in patients who underwent lymph node dissection without liver resection (80.3% vs 30.0%, P = .032), and the extent of liver resection was not associated with overall survival (P = .526). Lymph node dissection without liver resection was an independent prognostic factor for overall survival in hepatic-sided T2 gallbladder cancer (hazard ratio 5.009, 95% confidence interval 1.512-16.596, P = .008). In peritoneal-sided T2 patients, the 5-year overall survival was not significantly different between the lymph node dissection with liver resection and the lymph node dissection without liver resection subgroups (70.5% vs 54.8%, P = .111) and the extent of lymph node dissection was not associated with overall survival (P = .395).ConclusionIn peritoneal-sided T2 gallbladder cancer, radical cholecystectomy including lymph node dissection without liver resection is a reasonable operative option. Radical cholecystectomy including lymph node dissection with liver resection is suitable for hepatic-sided T2 gallbladder cancer.Copyright © 2017 Elsevier Inc. All rights reserved.

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