title: Aspects on gallbladder cancer in 2014.
abstract: OBJECTIVE
  To discuss some key issues involved in the management of gallbladder cancer (GBC).
  
  
  RESULTS
  The decline in incidence and mortality of GBC began decades before the introduction of laparoscopic surgery. In consecutive autopsies and in cases in which cholelithiasis was present, the incidence of gallbladder carcinoma is 3-4%. A number of genetic alterations have been identified in the different stages of GBC and they support the morphological evidence of two pathways by which tumors develop. Some of these genetic changes are associated with particular risk factors. All management of GBC and all comparisons of treatment results from different centers must be based on the stages.
  
  
  CONCLUSIONS
  Simple cholecystectomy is the adequate treatment for T1a GBC. Lymph node excision improved survival in patients with T2 lesions. Radical en bloc resection of T2 tumors offers greater benefit over conventional cholecystectomy alone in terms of greater long-term survival times. Provided that negative surgical margins are secured, hepatectomy and lymph node resection can, therefore, be withheld in most cases in the surgical treatment of pT2 GBC. With improvements in surgical and anesthetic techniques, aggressive surgery has proven to be performed with safety.
authors.affiliation: aDepartment of Surgery, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden bDepartment of Surgery, Ruijin Hospital, Medical School of Shanghai Jiaotong University, Shanghai, People's Republic of China.
authors.forename: Ake
authors.initials: A
authors.lastname: Åndrén-Sandberg
authors.forename: Yang
authors.initials: Y
authors.lastname: Deng
mesh_terms: D002763:Cholecystectomy / Q000379:methods; D005706:Gallbladder Neoplasms / Q000453:epidemiology / Q000235:genetics / Q000473:pathology / Q000601:surgery*; D020022:Genetic Predisposition to Disease; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging