Hyeong Seok Kim1, Jae Woo Park1,2, Hongbeom Kim1, Youngmin Han1, Wooil Kwon1, Sun-Whe Kim1, Yoon Jin Hwang3, Sang Geol Kim3, Hyung Jun Kwon3, Eduardo Vinuela4, Nicolas Járufe4, Juan Carlos Roa5, In Woong Han6, Jin Seok Heo6, Seong-Ho Choi6, Dong Wook Choi6, Keun Soo Ahn7, Koo Jeong Kang7, Woohyung Lee8, Chi-Young Jeong8, Soon-Chan Hong8, Andres Troncoso9, Hector Losada9, Sung-Sik Han10, Sang-Jae Park10, Hiroaki Yanagimoto11, Itaru Endo12, Keiichi Kubota13, Toshifumi Wakai14, Tetsuo Ajiki15, Nazmi Volkan Adsay16,17, Jin-Young Jang1. 1. Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea. 2. Department of Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, South Korea. 3. School of Medicine, Kyungpook National University, Daegu, South Korea. 4. Department of Digestive Surgery, Faculty of Medicine, Catholic University of Chile, Santiago, Chile. 5. Department of Pathology, Faculty of Medicine, Catholic University of Chile, Santiago, Chile. 6. Department of Surgery, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, South Korea. 7. Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Keimyung University Dongsan Medical Center, Daegu, South Korea. 8. Department of Surgery, Gyeongsang National University College of Medicine, Jinju, South Korea. 9. Surgery Department, Universidad de la Frontera, Temuco, Chile. 10. Department of Surgery, Center for Liver Cancer, National Cancer Center, Goyang, South Korea. 11. Department of Surgery, Kansai Medical University, Hirakata, Japan. 12. Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan. 13. Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan. 14. Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. 15. Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. 16. Department of Pathology, Koc University, Istanbul, Turkey. 17. Department of Pathology, Emory University School, Atlanta, GA, USA.
Abstract
BACKGROUND: There is no consensus on the optimal treatment of T1b gallbladder cancer (GBC) due to the lack of evidence and the difficulty of anatomy and pathological standardization. METHODS: A total of 272 patients with T1b GBC who underwent surgical resection at 14 centers 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 147 women. Simple cholecystectomy (SC) was performed in 116 patients (48.9%) and extended cholecystectomy (EC) in 121 patients (51.1%). The overall 5-year DSS was 94.6%, and it was similar between SC and EC patients (93.7% vs. 95.5%, P = 0.496). The 5-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 not differ according to lymph node metastasis (P = 0.688) or tumor location (P = 0.474). CONCLUSIONS: SC showed similar clinical outcomes (including recurrence) and survival outcomes as EC; therefore, EC is not needed for the treatment of T1b GBC.
BACKGROUND: There is no consensus on the optimal treatment of T1b gallbladder cancer (GBC) due to the lack of evidence and the difficulty of anatomy and pathological standardization. METHODS: A total of 272 patients with T1b GBC who underwent surgical resection at 14 centers 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 147 women. Simple cholecystectomy (SC) was performed in 116 patients (48.9%) and extended cholecystectomy (EC) in 121 patients (51.1%). The overall 5-year DSS was 94.6%, and it was similar between SC and EC patients (93.7% vs. 95.5%, P = 0.496). The 5-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 not differ according to lymph node metastasis (P = 0.688) or tumor location (P = 0.474). CONCLUSIONS: SC showed similar clinical outcomes (including recurrence) and survival outcomes as EC; therefore, EC is not needed for the treatment of T1b GBC.