Systematic review on the surgical treatment for T1 gallbladder cancer.
OBJECTIVE
To evaluate the efficacy of simple and extended cholecystectomy for mucosa (T1a) or muscularis (T1b) gallbladder (GB) cancer.


METHODS
Original studies on simple and extended cholecystectomy for T1a or T1b GB cancer were searched from MEDLINE (PubMed), Cochrane Library, EMBase, and CancerLit using the search terms of GB, cancer/carcinoma/tumor/neoplasm.


RESULTS
Twenty-nine out of the 2312 potentially relevant publications met the eligibility criteria. Of the 1266 patients with GB cancer included in the publications, 706 (55.8%) and 560 (44.2%) had T1a and T1b GB cancer, respectively. Simple cholecystectomy for T1a and T1b GB cancer was performed in 590 (83.6%) and 375 (67.0%) patients, respectively (P < 0.01). In most series, the treatment of choice was simple cholecystectomy for T1a GB cancer patients with a 5-year survival rate of 100%. Lymph node metastasis was detected in 10.9% of the T1b GB cancer patients and in 1.8% of the T1a GB cancer patients, respectively (P < 0.01). Eight patients (1.1%) with T1a GB cancer and 52 patients (9.3%) with T1b GB cancer died of recurrent GB cancer (P < 0.01).


CONCLUSIONS
Simple cholecystectomy represents the adequate treatment of T1a GB cancer. There is no definite evidence that extended cholecystectomy is advantageous over simple cholecystectomy for T1b GB cancer.
University College of Medicine, Seoul 140-757, South Korea.
Seung Eun
SE
Lee
Jin-Young
JY
Jang
Chang-Sup
CS
Lim
Mee Joo
MJ
Kang
Sun-Whe
SW
Kim
D002763:Cholecystectomy / Q000379:methods; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005706:Gallbladder Neoplasms / Q000601:surgery*; D005753:Gastric Mucosa / Q000601:surgery; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008207:Lymphatic Metastasis; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D013514:Surgical Procedures, Operative; D016896:Treatment Outcome
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