# Tumor location is a strong predictor of tumor progression and survival in T2 gallbladder cancer: an international multicenter study

Source: https://onco.cc/key-papers/paper-shindoh-t2-gallbladder-cancer-tumour-location-ann-surg-2015/  
OnCo record `paper-shindoh-t2-gallbladder-cancer-tumour-location-ann-surg-2015` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Where a muscle-invading gallbladder tumour sits matters: those on the side against the liver spread more and killed more, with five-year survival of 43 in 100 against 65 in 100 for tumours on the free side.

## Summary

Four institutions analysed 437 resected gallbladder cancers, defining tumour location as hepatic side or peritoneal side. Among 252 T2 tumours, hepatic-side tumours (99) had more vascular invasion (51 versus 19 percent), neural invasion (33 versus 8 percent) and nodal metastasis (40 versus 17 percent) than peritoneal-side tumours (153). After a median follow-up of 58.9 months, three- and five-year survival was 52.1 and 42.6 percent for hepatic-side and 73.7 and 64.7 percent for peritoneal-side T2 tumours (p=0.0006); no such difference was seen for T1 or T3. Hepatic-side location was independently associated with survival (hazard ratio 2.7, 95 percent CI 1.7 to 4.2) and predicted liver recurrence (23 versus 3 percent) and distant nodal recurrence (16 versus 3 percent) even after radical resection.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Tags: gallbladder-evidence
- Journal: Annals of Surgery
- Year: 2015
- DOI: 10.1097/SLA.0000000000000728
- Authors: Shindoh J, de Aretxabala X, Aloia TA, et al.
- Findings: Five-year survival 42.6 percent for hepatic-side vs 64.7 percent for peritoneal-side T2 tumours (p=0.0006).; Hepatic-side location: hazard ratio 2.7 (95 percent CI 1.7 to 4.2) for death; nodal metastasis 40 vs 17 percent.; Liver recurrence 23 vs 3 percent and distant nodal recurrence 16 vs 3 percent after radical resection.
- What it means: The study behind the T2a/T2b split adopted by the AJCC eighth edition in 2017, the one staging change in gallbladder cancer that grew from the disease's own anatomy rather than from bile duct cancer.
- Caveats: Retrospective, four referral centres.; Location was assigned on pathology review; reproducibility between pathologists is a known difficulty.

## Sources

- Ann Surg 2015: https://doi.org/10.1097/SLA.0000000000000728
- PubMed: https://pubmed.ncbi.nlm.nih.gov/24854451/

## Connected records

- cancers: [Gallbladder cancer](https://onco.cc/cancers/gallbladder/)
- institutions: [MD Anderson Cancer Center](https://onco.cc/institutions/md-anderson/)
- terms: [T2a versus T2b gallbladder cancer (peritoneal side versus hepatic side)](https://onco.cc/terms/t2a-versus-t2b/), [TNM staging](https://onco.cc/terms/tnm-staging/)
- key papers: [8th Edition of the AJCC Cancer Staging Manual: Pancreas and Hepatobiliary Cancers](https://onco.cc/key-papers/paper-chun-ajcc-8th-edition-hepatobiliary-aso-2018/)
- 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: [A trial of sparing the liver resection in peritoneal-side (T2a) gallbladder cancer](https://onco.cc/ideas/idea-gbc-t2a-spare-liver-resection-trial/)

---
JSON: https://onco.cc/api/v1/entities/paper-shindoh-t2-gallbladder-cancer-tumour-location-ann-surg-2015.json