title: Surgical strategy for T1 gallbladder cancer: a nationwide multicenter survey in South Korea.
abstract: BACKGROUND
  The aim of this study was to investigate the clinical features and clinical outcomes of T1 gallbladder (GB) cancer and to determine an appropriate surgical strategy for T1 GB cancer.
  
  
  METHODS
  A nationwide multicenter study, in which 16 University Hospitals in Korea participated, was performed from 1995 to 2004. A total of 258 patients, 117 patients with T1a and 141 patients with T1b disease were enrolled. Clinicopathologic findings and long-term follow-up results were analyzed after a consensus meeting of the Korean Pancreas Surgery Club was held.
  
  
  RESULTS
  Simple cholecystectomy was performed in 95 patients (81.2 %) with T1a tumor and in 89 patients (63.1 %) with T1b tumor (p < 0.01). Lymph node metastasis was observed in 2.9 % of T1a patients and in 9.9 % of T1b patients (p = 0.391). A significant difference in 5-year disease-specific survival (DSS) rates was observed between T1a and T1b patients (96.4 vs 84.8 %, respectively, p = 0.03). However, no significant 5-year DSS rate difference was observed between those who underwent simple cholecystectomy or extended cholecystectomy, regardless of whether lymph node dissection was performed or whether lymph node metastasis was present. There was no significant difference in recurrence-free survival between simple cholecystectomy and extended cholecystectomy.
  
  
  CONCLUSIONS
  There was no superiority of extended cholecystectomy over simple cholecystectomy in the aspect of survival and recurrence especially in T1b gallbladder cancer. Furthermore, the effectiveness of regional lymphadenectomy for treatment purpose remains questionable. Therefore, simple cholecystectomy could be recommended as a surgical strategy of T1 gallbladder cancer.
authors.affiliation: Department of Surgery, Chung-Ang University School of Medicine, Seoul, South Korea.
authors.forename: Seung Eun
authors.initials: SE
authors.lastname: Lee
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Jang
authors.forename: Sun-Whe
authors.initials: SW
authors.lastname: Kim
authors.forename: Ho-Seong
authors.initials: HS
authors.lastname: Han
authors.forename: Hong-Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Sung-Su
authors.initials: SS
authors.lastname: Yun
authors.forename: Baik-Hwan
authors.initials: BH
authors.lastname: Cho
authors.forename: Hee Chul
authors.initials: HC
authors.lastname: Yu
authors.forename: Woo Jung
authors.initials: WJ
authors.lastname: Lee
authors.forename: Dong-Sup
authors.initials: DS
authors.lastname: Yoon
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Choi
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Soon-Chan
authors.initials: SC
authors.lastname: Hong
authors.forename: Sang-Mok
authors.initials: SM
authors.lastname: Lee
authors.forename: Hyun Jong
authors.initials: HJ
authors.lastname: Kim
authors.forename: In Seok
authors.initials: IS
authors.lastname: Choi
authors.forename: In-Sang
authors.initials: IS
authors.lastname: Song
authors.forename: Sang-Jae
authors.initials: SJ
authors.lastname: Park
authors.forename: Sungho
authors.initials: S
authors.lastname: Jo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy; D005260:Female; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006306:Health Surveys; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011379:Prognosis; D056910:Republic of Korea; D015996:Survival Rate