Surgical Strategy for T2 Gallbladder Cancer: Nationwide Multicenter Survey in Korea.
10.3346/jkms.2018.33.e186
- Author:
Seung Eun LEE
1
;
Sun Whe KIM
;
Ho Seong HAN
;
Woo Jung LEE
;
Dong Sup YOON
;
Baik Hwan CHO
;
In Seok CHOI
;
Hyun Jong KIM
;
Soon Chan HONG
;
Sang Mok LEE
;
Dong Wook CHOI
;
Sang Jae PARK
;
Hong Jin KIM
;
Jin Young JANG
Author Information
1. Department of Surgery, Chung-Ang University School of Medicine, Seoul, Korea.
- Publication Type:Multicenter Study ; Randomized Controlled Trial ; Original Article
- Keywords:
Gallbladder;
Carcinoma;
Simple;
Extended;
Cholecystectomy
- MeSH:
Cholecystectomy;
Consensus;
Follow-Up Studies;
Gallbladder Neoplasms*;
Gallbladder*;
Hospitals, University;
Humans;
Korea*;
Lymph Nodes;
Multivariate Analysis;
Neoplasm Metastasis;
Pancreas;
Recurrence;
Survival Rate
- From:Journal of Korean Medical Science
2018;33(28):e186-
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Although all guidelines suggest that T2 gallbladder (GB) cancer should be treated by extended cholecystectomy (ECx), high-level scientific evidence is lacking because there has been no randomized controlled trial on GB cancer. METHODS: A nationwide multicenter study between 2000 and 2009 from 14 university hospitals enrolled a total of 410 patients with T2 GB cancer. The clinicopathologic findings and long-term follow-up results were analyzed after consensus meeting of Korean Pancreas Surgery Club. RESULTS: The 5-year cumulative survival rate (5YSR) for the patients who underwent curative resection was 61.2%. ECx group showed significantly better 5YSR than simple cholecystectomy (SCx) group (65.4% vs. 54.0%, P = 0.016). For N0 patients, there was no significant difference in 5YSR between SCx and ECx groups (68.7% vs. 73.6%, P = 0.173). Systemic recurrence was more common than locoregional recurrence (78.5% vs. 21.5%). Elevation of cancer antigen 19-9 level preoperatively and lymph node (LN) metastasis were significantly poor prognostic factors in a multivariate analysis. CONCLUSION: ECx including wedge resection of GB bed should be recommended for T2 GB cancer. Because systemic recurrence was more common and recurrence occurred more frequently in patients with LN metastasis, postoperative adjuvant therapy should be considered especially for the patients with LN metastasis.
