• World J Surg Oncol · Jan 2019

    Validation of the oncologic effect of hepatic resection for T2 gallbladder cancer: a retrospective study.

    • Jin-Kyu Cho, Woohyung Lee, Jae Yool Jang, Han-Gil Kim, Jae-Myung Kim, Seung-Jin Kwag, Ji-Ho Park, Ju-Yeon Kim, Taejin Park, Sang-Ho Jeong, Young-Tae Ju, Eun-Jung Jung, Young-Joon Lee, Soon-Chan Hong, and Chi-Young Jeong.
    • Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University Postgraduate School of Medicine, 79, Gangnam-ro, Jinju, 660-702, South Korea.
    • World J Surg Oncol. 2019 Jan 7; 17 (1): 8.

    BackgroundWhile extended cholecystectomy is recommended for T2 gallbladder cancer (GBC), the role of hepatic resection for T2 GBC is unclear. This study aimed to identify the necessity of hepatic resection in patients with T2 GBC.MethodsData of 81 patients with histopathologically proven T2 GBC who underwent surgical resection between January 1999 and December 2017 were enrolled from a retrospective database. Of these, 36 patients had peritoneal-side (T2a) tumors and 45 had hepatic-side (T2b) tumors. To identify the optimal surgical management method, T2 GBC patients were classified into the hepatic resection group (n = 44, T2a/T2b = 20/24) and non-hepatic resection group (n = 37, T2a/T2b = 16/21). The recurrence pattern and role of hepatic resection for T2 GBC were then investigated.ResultsMean age of the patients was 69 (range 36-88) years, and the male-to-female ratio was 42:39 (male, 51.9%; female, 48.1%). Hepatic-side GBC had a higher rate of recurrence than peritoneal-side GBC (44.4% vs. 8.3%, p = 0.006). The most common type of recurrence in T2a GBC was para-aortic lymph node recurrence (n = 2, 5.6%); the most common types of recurrence in T2b GBC were para-aortic lymph node recurrence (n = 7, 15.6%) and intrahepatic metastasis (n = 6, 13.3%). Hepatic-side GBC patients had worse survival outcomes than peritoneal-side GBC patients (76.0% vs. 96.6%, p = 0.041). Hepatic resection had no significant treatment effect in T2 GBC patients (p = 0.272). Multivariate analysis showed that lymph node metastasis was the only significant prognostic factor (p = 0.002).ConclusionsHepatic resection is not essential for curative treatment in T2 GBC, and more systemic treatments are needed for GBC patients, particularly for those with T2b GBC.

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