{"entity":{"id":"paper-kim-t1b-gallbladder-cancer-international-jhbps-2018","kind":"paper","name":"Optimal surgical treatment in patients with T1b gallbladder cancer: An international multicenter study","aka":[],"tldr":"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).","asOf":"2026-09-24","links":[{"label":"J Hepatobiliary Pancreat Sci 2018","url":"https://doi.org/10.1002/jhbp.593"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/30562839/"}],"tags":["gallbladder-evidence"],"related":[],"cancers":["gallbladder"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["radical-cholecystectomy","incidental-gallbladder-cancer","tnm-staging"],"trials":[],"people":[],"bottlenecks":["b-trial-design"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"journal":"Journal of Hepato-Biliary-Pancreatic Sciences","year":2018,"doi":"10.1002/jhbp.593","pmid":"30562839","authors":"Kim HS, Park JW, Kim H, et al.","paperType":"observational","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."],"whatItMeans":"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."],"changedPractice":false,"participants":237},"route":"/key-papers/paper-kim-t1b-gallbladder-cancer-international-jhbps-2018/","neighbours":{"cancer":[{"id":"gallbladder","kind":"cancer","name":"Gallbladder cancer","route":"/cancers/gallbladder/"},{"id":"incidental-gallbladder-cancer","kind":"cancer","name":"Incidental gallbladder cancer (found after cholecystectomy)","route":"/cancers/incidental-gallbladder-cancer/"}],"term":[{"id":"radical-cholecystectomy","kind":"term","name":"Radical (extended) cholecystectomy","route":"/terms/radical-cholecystectomy/"},{"id":"tnm-staging","kind":"term","name":"TNM staging","route":"/terms/tnm-staging/"}],"bottleneck":[{"id":"b-trial-design","kind":"bottleneck","name":"Trial design, endpoints and cost","route":"/bottlenecks/b-trial-design/"}],"roadmap":[{"id":"gallbladder-cancer-roadmap","kind":"roadmap","name":"Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials","route":"/roadmaps/gallbladder-cancer-roadmap/"}],"idea":[{"id":"idea-gbc-t1b-simple-cholecystectomy-prospective-study","kind":"idea","name":"Test whether T1b gallbladder cancer needs the second operation at all","route":"/ideas/idea-gbc-t1b-simple-cholecystectomy-prospective-study/"}]}}