title: Early gallbladder cancer: is further treatment necessary?
abstract: OBJECTIVE
  The goal of this study was to evaluate a series of patients with early gallbladder cancer, focusing on the selection of treatment and the role of Rokitansky Aschoff sinus infiltration.
  
  
  METHODS
  We performed a retrospective analysis of a prospective series of 371 patients with gallbladder cancer. Specimens were reviewed by an independent pathologist to confirm the diagnosis and depth of infiltration and to evaluate the presence of Rokitansky Aschoff sinus involvement.
  
  
  RESULTS
  Forty-nine and 45 patients with muscular (pT1b) and mucosal (pT1a) infiltration gallbladder cancer tumors were studied respectively. Simple cholecystectomy was the treatment in all patients, with the exception of 11 patients who underwent further surgery. Rokitansky Aschoff sinus invasion was seen in seven patients with mucosa (pT1a) and three with muscular (pT1b) compromise. The 5-year survival rates of patients with muscular (pT1b) and mucosal (pT1a) infiltration were 87.6% and 86.4%, respectively. Patients with Rokitansky Aschoff involvement had a lower survival rate than those with no involvement in both categories.
  
  
  CONCLUSIONS
  Early gallbladder cancer is associated with a favorable prognosis and cholecystectomy should be the standard treatment. Despite some patients having a worse prognosis, there are no data to support more aggressive treatment.
authors.affiliation: Department of Surgery, Clinica Alemana, Santiago, Chile. xdearetxabala@alemana.cl
authors.forename: Xabier
authors.initials: X
authors.lastname: de Aretxabala
authors.forename: Ivan
authors.initials: I
authors.lastname: Roa
authors.forename: Juan
authors.initials: J
authors.lastname: Hepp
authors.forename: Fernando
authors.initials: F
authors.lastname: Maluenda
authors.forename: Gerardo
authors.initials: G
authors.lastname: Mordojovich
authors.forename: Jorge
authors.initials: J
authors.lastname: Leon
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Roa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy; D042241:Early Diagnosis; D005260:Female; D005706:Gallbladder Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D009130:Muscle, Smooth / Q000473:pathology; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D015996:Survival Rate