title: Gallbladder bed resection or hepatectomy of segments 4a and 5 for pT2 gallbladder carcinoma: analysis of Japanese registration cases by the study group for biliary surgery of the Japanese Society of Hepato-Biliary-Pancreatic Surgery.
abstract: OBJECTIVE
  Hepatectomy of segments 4a and 5 (S4a+5) is the recommended treatment for pT2 gallbladder cancer. However, gallbladder bed resection is also occasionally used. Using nationwide data from the Japanese Biliary Tract Cancer Registry and a questionnaire survey, we retrospectively compared these 2 methods of treatment.
  
  
  METHODS
  The study involved 85 patients with pT2, pN0 gallbladder cancer (55 treated with gallbladder bed resection, and 30, with S4a+5 hepatectomy). The prognosis and mode of tumor recurrence following treatment were analyzed retrospectively, with overall survival as the endpoint.
  
  
  RESULTS
  The 5-year survival rate did not differ significantly between the 2 groups. Univariate analysis showed that bile duct resection and perineural tumor invasion were significant prognostic factors, but the extent of hepatectomy, location of the major intramural tumor, regional lymph node excision, and histological type were not. Multivariate analysis identified perineural tumor invasion as a significant prognostic factor. Recurrence occurred most frequently in both lobes than S4a+5 of the liver following gallbladder bed resection.
  
  
  CONCLUSIONS
  In the present study of cases of Japanese Biliary Tract Cancer Registry, it was not possible to conclude that S4a+5 hepatectomy was superior to gallbladder bed resection.
authors: Department of Biliary-Pancreatic Surgery, Fujita Health University, Toyoake, Aichi, Japan. akihori@fujita-hu.ac.jp
authors: Akihiko
authors: A
authors: Horiguchi
authors: Shuichi
authors: S
authors: Miyakawa
authors: Shin
authors: S
authors: Ishihara
authors: Masaru
authors: M
authors: Miyazaki
authors: Masayuki
authors: M
authors: Ohtsuka
authors: Hiroaki
authors: H
authors: Shimizu
authors: Keiji
authors: K
authors: Sano
authors: Fumihiko
authors: F
authors: Miura
authors: Tetsuo
authors: T
authors: Ohta
authors: Masato
authors: M
authors: Kayahara
authors: Masato
authors: M
authors: Nagino
authors: Tsuyoshi
authors: T
authors: Igami
authors: Satoshi
authors: S
authors: Hirano
authors: Hiroki
authors: H
authors: Yamaue
authors: Masaji
authors: M
authors: Tani
authors: Masakazu
authors: M
authors: Yamamoto
authors: Takehiro
authors: T
authors: Ota
authors: Mitsuo
authors: M
authors: Shimada
authors: Yuji
authors: Y
authors: Morine
authors: Hisafumi
authors: H
authors: Kinoshita
authors: Masafumi
authors: M
authors: Yasunaga
authors: Tadahiro
authors: T
authors: Takada
mesh_terms: D000368:Aged; D005260:Female; D005706:Gallbladder Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008197:Lymph Node Excision; D008297:Male; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D015996:Survival Rate