Optimal surgical treatment in patients with T1b gallbladder cancer:An international multicenter study

Abstract

Background There is no consensus on the optimal treatment of T1b gallbladdercancer (GBC) due to the lack of evidence and the difficulty of anatomy andpathological standardization.

Methods A total of 272 patients with T1b GBC who underwent surgical resection at 14centers with specialized hepatobiliary-pancreatic surgeons and pathologists in Korea,Japan, Chile, and the United States were studied. Clinical outcomes including disease-specific survival (DSS) rates according to the types of surgery were analyzed.

Results After excluding patients, the 237 qualifying patients consisted of 90 men and 147women. Simple cholecystectomy (SC) was performed in 116 patients (48.9%) andextended cholecystectomy (EC) in 121 patients (51.1%). The overall 5-year DSS was94.6%, and it was similar between SC and EC patients (93.7% vs. 95.5%, P = 0.496). The5-year DSS was similar between SC and EC patients in America (82.3% vs. 100.0%,P = 0.249) as well as in Asia (98.6% vs. 95.2%, P = 0.690). The 5-year DSS also did notdiffer according to lymph node metastasis (P = 0.688) or tumor location (P = 0.474).

Conclusions SC showed similar clinical outcom es (including recurrence) and survivaloutcomes as EC; therefore, EC is not needed for the treatmen t of T1b GBC.