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

Source: https://onco.cc/key-papers/paper-kim-t1b-gallbladder-cancer-international-jhbps-2018/  
OnCo record `paper-kim-t1b-gallbladder-cancer-international-jhbps-2018` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Across 14 specialist centres in Korea, Japan, Chile and the United States, people with a gallbladder cancer that had just reached the muscle layer did equally well whether or not they had a second, bigger operation: about 95 in 100 were alive and free of the disease at five years either way.

## Summary

Retrospective study of 272 patients with T1b gallbladder cancer resected at 14 centres with specialised hepatobiliary surgeons and pathologists; 237 qualified for analysis (90 men, 147 women). Simple cholecystectomy was performed in 116 (48.9 percent) and extended cholecystectomy in 121 (51.1 percent). Five-year disease-specific survival was 94.6 percent overall and did not differ between simple and extended cholecystectomy (93.7 versus 95.5 percent, p=0.496), in America (82.3 versus 100 percent, p=0.249) or Asia (98.6 versus 95.2 percent, p=0.690), nor by lymph node metastasis (p=0.688) or tumour location (p=0.474).

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Tags: gallbladder-evidence
- Journal: Journal of Hepato-Biliary-Pancreatic Sciences
- Year: 2018
- DOI: 10.1002/jhbp.593
- Authors: Kim HS, Park JW, Kim H, et al.
- Findings: Five-year disease-specific survival 93.7 percent after simple cholecystectomy vs 95.5 percent after extended cholecystectomy (p=0.496) in 237 T1b patients.; No difference by region, nodal status or tumour location.
- What it means: The strongest data against routine re-resection for T1b tumours, which guidelines still recommend. A prospective study or registry with standardised pathology is the missing step; the authors' own conclusion is that extended cholecystectomy is not needed for T1b.
- Caveats: Retrospective; patients offered simple cholecystectomy may have had favourable features.; Pathological standardisation of T1b across centres is itself difficult, as the authors note.

## Sources

- J Hepatobiliary Pancreat Sci 2018: https://doi.org/10.1002/jhbp.593
- PubMed: https://pubmed.ncbi.nlm.nih.gov/30562839/

## Connected records

- cancers: [Gallbladder cancer](https://onco.cc/cancers/gallbladder/), [Incidental gallbladder cancer (found after cholecystectomy)](https://onco.cc/cancers/incidental-gallbladder-cancer/)
- terms: [Radical (extended) cholecystectomy](https://onco.cc/terms/radical-cholecystectomy/), [TNM staging](https://onco.cc/terms/tnm-staging/)
- bottlenecks: [Trial design, endpoints and cost](https://onco.cc/bottlenecks/b-trial-design/)
- roadmaps: [Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials](https://onco.cc/roadmaps/gallbladder-cancer-roadmap/)
- ideas: [Test whether T1b gallbladder cancer needs the second operation at all](https://onco.cc/ideas/idea-gbc-t1b-simple-cholecystectomy-prospective-study/)

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