• Yeshong Park, Jun Suh Lee, Boram Lee, Yeongsoo Jo, Eunhye Lee, MeeYoung Kang, Wooil Kwon, Chang-Sup Lim, Jin-Young Jang, Ho-Seong Han, and Yoo-Seok Yoon.
• Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea.
• Ann. Surg. 2023 Dec 1; 278 (6): 985993985-993.

ObjectiveThis study aimed to evaluate the effect of liver resection on the prognosis of T2 gallbladder cancer (GBC).BackgroundAlthough extended cholecystectomy [lymph node dissection (LND) + liver resection] is recommended for T2 GBC, recent studies have shown that liver resection does not improve survival outcomes relative to LND alone.MethodsPatients with pT2 GBC who underwent extended cholecystectomy as an initial procedure and did not reoperation after cholecystectomy at 3 tertiary referral hospitals between January 2010 and December 2020 were analyzed. Extended cholecystectomy was defined as either LND with liver resection (LND+L group) or LND only (LND group). We conducted 2:1 propensity score matching to compare the survival outcomes of the groups.ResultsOf the 197 patients enrolled, 100 patients from the LND+L group and 50 from the LND group were successfully matched. The LND+L group experienced greater estimated blood loss ( P <0.001) and a longer postoperative hospital stay ( P =0.047). There was no significant difference in the 5-year disease-free survival (DFS) of the 2 groups (82.7% vs 77.9%, respectively, P =0.376). A subgroup analysis showed that the 5-year DFS was similar in the 2 groups in both T substages (T2a: 77.8% vs 81.8%, respectively, P =0.988; T2b: 88.1% vs 71.5%, respectively, P =0.196). In a multivariable analysis, lymph node metastasis [hazard ratio (HR) 4.80, P =0.006] and perineural invasion (HR 2.61, P =0.047) were independent risk factors for DFS; liver resection was not a prognostic factor (HR 0.68, P =0.381).ConclusionsExtended cholecystectomy including LND without liver resection may be a reasonable treatment option for selected T2 GBC patients.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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