title: Role of cholecystectomy and lymph node dissection in patients with T2 gallbladder cancer.
abstract: BACKGROUND
  Incidental findings of gallbladder cancer (GBCA) have dramatically increased as an initial presentation of the disease because of the expansion of laparoscopic cholecystectomy. However, the optimal management of T2 GBCA remains at issue.
  
  
  METHODS
  We compared our 10-year experience with the consensus surgical strategy for T2 GBCA. Between January 2000 and December 2009, 70 patients at Severance Hospital, Yonsei University Health System, Seoul, Korea, underwent surgical treatment for GBCA stage T2. The medical records of 70 patients with T2 GBCA were retrospectively reviewed.
  
  
  RESULTS
  Radical cholecystectomy was performed on only 32 (45.8 %) patients. In patients with T2 GBCA and positive lymph nodes (LN), the overall survival rate between cholecystectomy with LN dissection and radical cholecystectomy did not show a significant difference. Twenty patients experienced recurrence during the follow-up period. Among the 11 patients who underwent cholecystectomy with liver resection, only 2 (18.2 %) patients had an intrahepatic recurrence. Of the 9 patients who underwent cholecystectomy without liver resection, 3 (33.3 %) patients had an intrahepatic recurrence. However, recurrences at the gallbladder bed occurred only in one and two patients, respectively, and were not significantly different between the two groups.
  
  
  CONCLUSIONS
  There was a large gap between clinical practice and treatment guidelines. Though relatively few patients enrolled in this study experienced recurrence, cholecystectomy and LN dissection without liver resection showed similar survival and recurrence patterns compared with those of radical cholecystectomy. To improve consistency between clinical practice and consensus guidelines, the role of limited resection for T2 lesions needs further evaluation.
authors: Dong Hyun
authors: DH
authors: Kim
authors: Sung Hoon
authors: SH
authors: Kim
authors: Gi Hong
authors: GH
authors: Choi
authors: Chang Moo
authors: CM
authors: Kang
authors: Kyung Sik
authors: KS
authors: Kim
authors: Jin Sub
authors: JS
authors: Choi
authors: Woo Jung
authors: WJ
authors: Lee
mesh_terms: D000368:Aged; D017081:Cholecystectomy, Laparoscopic; D003952:Diagnostic Imaging; D005260:Female; D005706:Gallbladder Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D033162:Incidental Findings; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
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