Role of cholecystectomy and lymph node dissection in patients with T2 gallbladder cancer

Dong Hyun Kim, Sung Hoon Kim, Gi Hong Choi, Chang Moo Kang, Kyung Sik Kim, Jin Sub Choi, Woo Jung Lee

Research output: Contribution to journalArticle

13 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)2635-2640
Number of pages6
JournalWorld Journal of Surgery
Volume37
Issue number11
DOIs
Publication statusPublished - 2013 Nov

All Science Journal Classification (ASJC) codes

  • Surgery

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