Effects of Surgical Methods and Tumor Location on Survival and Recurrence Patterns after Curative Resection in Patients with T2 Gallbladder Cancer.
OBJECTIVE
Extended cholecystectomy is generally recommended for patients with T2 gallbladder cancer. However, few studies have assessed the extent of resection relative to T2 gallbladder tumor location. This study analyzed the effects of surgical methods and tumor location on survival outcomes and tumor recurrence in patients with T2 gallbladder cancer.


METHODS
Clinicopathological characteristics, extent of resection, survival rates, and recurrence patterns were retrospectively analyzed in 88 patients with pathologically confirmed T2 gallbladder cancer.


RESULTS
The 5-year disease-free survival rate was 65.0%. Multivariate analysis showed that lymph node metastasis was the only independent risk factor for poor 5-year disease-free survival rate. Survival outcomes were not associated with tumor location. Survival tended to be better in patients who underwent extended cholecystectomy than in those who underwent simple cholecystectomy. Recurrence rate was not affected by surgical method or tumor location. Systemic recurrence was more frequent than local recurrence without distant recurrence. Gallbladder bed recurrence and liver recurrence were relatively rare, occurring only in patients with liver side tumors.


CONCLUSIONS
Extended cholecystectomy is the most appropriate treatment for T2 gallbladder cancer. However, simple cholecystectomy with regional lymph node dissection may be appropriate for patients with serosal side tumors.
Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Woohyun
W
Jung
Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Jin-Young
JY
Jang
Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Mee Joo
MJ
Kang
Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Ye Rim
YR
Chang
Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Yong Chan
YC
Shin
Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Jihoon
J
Chang
Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Sun-Whe
SW
Kim
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy / Q000379:methods* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D005704:Gallbladder / Q000473:pathology; D005706:Gallbladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology* / Q000473:pathology; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
Cholecystectomy; Gallbladder neoplasms; Recurrence; Survival; Tumor location