title: Optimal surgical treatment for patients with pT2 gallbladder cancer.
abstract: OBJECTIVE
  Wall invasion is one of the significant prognostic factors of gallbladder cancer (GBC). Even extended surgery associated with hepatectomy does not always improve the prognosis of pathological T2 (pT2) (the tumor invades perimuscular connective tissue pathologically) GBC patients. The purpose of this study was to identify factors associated with long-term survival of pT2 GBC patients.
  
  
  METHODS
  Fifty-three patients with GBC had undergone radical resection from 1995 to 2009 in our institution. Among them, there were 23 pT2 patients. We reviewed clinico-pathologic features of the pT2 GBC patients and evaluated prognostic factors.
  
  
  RESULTS
  The 5-year survival rates for pT1, pT2, pT3, and pT4 in TNM classification by the International Union against Cancer (UICC) were 100%, 55.2%, 38.5% and 25.0%, respectively. In the 23 patients with pT2 GBC, the absence of lymph node metastasis and a periductal cancer-free surgical margin were significant favorable factors by univariate analysis. The 5-year survival rate of pT2 GBC patients with a periductal cancer-free surgical margin was 65.8% and that of pT2 GBC patients who did not have lymph node metastasis was 71.2%.
  
  
  CONCLUSIONS
  In the treatment of pT2 GBC patients, radical resection to achieve RO including surgical margins and lymph nodes in spite of surgical procedures contributes to a better survival.
authors.affiliation: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho Hirokoji Kawaramachi, Kamigyo-ku, Kyoto, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Harada
authors.forename: Toshiya
authors.initials: T
authors.lastname: Ochiai
authors.forename: Koji
authors.initials: K
authors.lastname: Inoue
authors.forename: Koji
authors.initials: K
authors.lastname: Soga
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Murayama
authors.forename: Shuhei
authors.initials: S
authors.lastname: Komatsu
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shiozaki
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kuriu
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ikoma
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ichikawa
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.forename: Yukihito
authors.initials: Y
authors.lastname: Kokuba
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Sonoyama
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005706:Gallbladder Neoplasms / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome