Surgical Strategy for T2 Gallbladder Cancer According to Tumor Location
A Korean series suggesting that muscle-invading gallbladder tumours on the free side may not always need part of the liver removed, while those against the liver bed do.
Overview
Single-centre Korean series of 157 T2 gallbladder cancers resected with curative intent between 2000 and 2011: 33 peritoneal-side and 124 hepatic-side (epicentre in the gallbladder bed or neck); 122 had hepatic resection and 35 did not. After a median follow-up of 40 months, peritoneal-side tumours had better survival (p=0.002). Tumour location, lymph node metastasis, hepatic resection, lymphatic invasion and perineural invasion were independent prognostic factors. The authors recommend hepatic resection for hepatic-side tumours and suggest it is not always necessary for selected peritoneal-side tumours.
- 157 T2 tumours: 33 peritoneal-side, 124 hepatic-side; peritoneal-side survival better (p=0.002).
- Tumour location, nodal metastasis, hepatic resection, lymphatic and perineural invasion were independent prognostic factors.
One of the series that raised the question of sparing the liver resection in T2a disease; only 33 peritoneal-side tumours, so it poses the question rather than settles it.
- Single centre, retrospective, small peritoneal-side group.
- Location definitions differ from later studies.
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