Annals of Surgical Oncology

, Volume 22, Issue 8, pp 2779–2786 | Cite as

Surgical Strategy for T2 Gallbladder Cancer According to Tumor Location

  • Huisong Lee
  • Dong Wook Choi
  • Jin Young Park
  • Sangmin Youn
  • Wooil Kwon
  • Jin Seok Heo
  • Seong Ho Choi
  • Kee-Taek Jang
Hepatobiliary Tumors

Abstract

Background

Radical cholecystectomy is recommended for T2 gallbladder cancer. However, it is unclear whether hepatic resection is essential for peritoneal-side gallbladder cancer.

Methods

From January 2000 to December 2011, we identified T2 gallbladder cancer patients who had undergone curative intent surgery. A peritoneal-side tumor was defined when the epicenter of the tumor was located within the free peritoneal-side gallbladder mucosa. Hepatic-side gallbladder cancer was defined when the epicenter of the tumor was located within the gallbladder bed or neck.

Results

A total of 157 patients with T2 gallbladder cancer were included; 33 peritoneal-side and 124 hepatic-side tumors. In total, 122 patients underwent hepatic resection, whereas the remaining 35 patients did not. After a median follow-up period of 40 (range 5–170) months, the survival of the peritoneal-side group was better than that of the hepatic-side group (p = 0.002). In a multivariate analysis, tumor location, lymph node metastasis, hepatic resection, lymphatic invasion, and perineural invasion were significant prognostic factors (p = 0.045, p < 0.001, p = 0.003, p = 0.046, and p = 0.027, respectively). For the peritoneal-side group, there was no recurrence or death after cholecystectomy without hepatic resection. However, hepatic resection was an important factor associated with overall survival in patients with hepatic-side gallbladder cancer (p = 0.007).

Conclusions

In T2 gallbladder cancer patients, hepatic resection is recommended when there is tumor invasion of the gallbladder bed or neck. However, it is not always necessary in selected patients with peritoneal-side gallbladder cancer.

Keywords

Lymph Node Dissection Hepatic Resection Cystic Duct Gallbladder Cancer Lymph Node Recurrence 

Notes

Acknowledgment

There has been no grant support.

Disclosure

Huisong Lee, Dong Wook Choi, Jin Young Park, Sangmin Youn, Wooil Kwon, Jin Seok Heo, Seong Ho Choi, and Kee-Taek Jang have none to declare.

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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Huisong Lee
    • 1
  • Dong Wook Choi
    • 1
  • Jin Young Park
    • 1
  • Sangmin Youn
    • 1
  • Wooil Kwon
    • 1
  • Jin Seok Heo
    • 1
  • Seong Ho Choi
    • 1
  • Kee-Taek Jang
    • 2
  1. 1.Department of Surgery, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea
  2. 2.Department of Pathology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulKorea

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