title: Hepatic resection in 485 R0 pT2 and pT3 cases of advanced carcinoma of the gallbladder: results of a Japanese Society of Biliary Surgery survey--a multicenter study.
abstract: OBJECTIVE
  We conducted this study to evaluate the optimal hepatic resection for pT2 and pT3 advanced carcinoma of the gallbladder without invasion of the hepatoduodenal ligament.
  
  
  METHODS
  We conducted a questionnaire survey regarding 4,243 cases of carcinoma of the gallbladder treated during the recent 10-year period at 112 institutions belonging to the Japanese Society of Biliary Surgery. The questionnaires included questions on preoperative-diagnosis, complications, treatment, and surgical treatment, procedures of resection, surgical result, path histological findings, mode, and site of recurrence, additional post-operative treatment. They included 293 pT2 and 192 pT3 R0 cases, which were negative for hepatoduodenal ligament invasion, and the cumulative survival rates and sites of postoperative recurrence in the form of liver metastasis, were retrospectively analyzed in these 485 cases.
  
  
  RESULTS
  There were no significant differences in survival rate or recurrence rates in the form of liver metastasis between the groups that underwent resection of the gallbladder bed, the group that underwent segmentectomy 4a+5, and the group that underwent hepatectomy in patients with of both pT2 or pT3 gallbladder cancers. Our results also did not show that liver metastasis to segment 4a5 alone was particularly common.
  
  
  CONCLUSIONS
  For gallbladder cancer, neither with hepatoduodenal ligament invasion nor hepatic invasion, resection of the gallbladder bed is more preferable for surgical hepatic procedure. For gallbladder cancer that invades any hepatic sites, a hepatic surgical procedure that could eliminate surgical margins would be desirable.
authors.affiliation: Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Yachiyo, Chiba, Japan. araida@tymc.twmu.ac.jp
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Araida
authors.forename: Ryouta
authors.initials: R
authors.lastname: Higuchi
authors.forename: Mie
authors.initials: M
authors.lastname: Hamano
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Kodera
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Takeshita
authors.forename: Takehiro
authors.initials: T
authors.lastname: Ota
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Ken
authors.initials: K
authors.lastname: Takasaki
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D005260:Female; D005706:Gallbladder Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D015996:Survival Rate; D016896:Treatment Outcome