Surgical Outcomes and Prognostic Factors for T2 Gallbladder Cancer Following Surgical Resection

• Published in: Journal of gastrointestinal surgery Vol. 14; no. 4; pp. 668 - 678
• Main Authors: Choi, Sae Byeol, Han, Hyung Joon, Kim, Chung Yun, Kim, Wan Bae, Song, Tae-Jin, Suh, Sung Ock, Kim, Young Chul, Choi, Sang Yong
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.04.2010; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Biopsy; Chi-Square Distribution; Cholecystectomy - methods; Disease-Free Survival; Dissection; Female; Gallbladder Neoplasms - pathology; Gallbladder Neoplasms - surgery; Gastroenterology; Humans; Lymph Node Excision; Lymphatic Metastasis; Lymphatic system; Male; Medicine; Medicine & Public Health; Middle Aged; Multivariate analysis; Neoplasm Staging; Original Article; Prognosis; Proportional Hazards Models; Retrospective Studies; Surgery; Surgical outcomes; Treatment Outcome; Cholecystectomy; Lymph node dissection; T2 gallbladder cancer; Radical surgery
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-009-1132-z

Background Depth of tumor invasion is an important prognostic factor for gallbladder cancer. The aim of this study was to investigate the clinicopathological prognostic factors of T2 gallbladder cancer. Methods We retrospectively reviewed the clinicopathological data and survival for 83 patients with T2 gallbladder cancers who underwent surgical resection between January 1995 and December 2007. Results The overall survival rates were 48.9% at 3 years and 29.3% at 5 years. Univariate analysis revealed that R0 resection ( P  < 0.001), extended surgery ( P  = 0.028), lymph node dissection ( P  = 0.024), non-infiltrative tumors ( P  = 0.001), well differentiation ( P  = 0.001), absence of lymphatic ( P  = 0.025), perineural ( P  = 0.001), and vascular ( P  = 0.025) invasion, absence of lymph node metastasis ( P  = 0.001), negative resection margin ( P  = 0.016), and stage ( P  = 0.002) were significantly better predictors for survival. A significant difference in survival between Rx and R1 was not found. R0 resection, lymph node dissection, well differentiation, and absence of perineural and vascular invasion were significantly independent prognostic factors for overall survival. Recurrence occurred in 48 patients (57.8%). Age older than 65 years, R0 resection, non-infiltrative tumors, and good differentiation were significant independent predictors of disease-free survival by multivariate analysis. Conclusions For T2 tumors, radical surgery including lymph node dissection should be performed to achieve R0 resection. Tumors with infiltrative types and suspicious lymph node metastasis in the intraoperative findings were candidates for aggressive surgical management to improve patient survival.