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Early carcinoma of the gallbladder
Y Shirai1, K Yoshida, K Tsukada
1Department of Surgery, Niigata University School of Medicine, Japan.
Objective:
To clarify the definition and clinicopathological characteristics of early cancer of the gallbladder.
Design:
Open study.
Setting:
University hospital.
Subjects:
78 patients with pathological stage T1a and 11 with pT1b tumours.
Interventions:
Of those with pT1a tumours, 51 were treated by simple, and 27 by radical, cholecystectomy. For those with pT1b tumours the figures were 5 and 11, respectively.
Results:
There were two recurrences, both in patients with pT1a tumours, histological examination of which had shown tumour present at the surgical margins. There were no cases of neurovascular invasion but only one case of lymphatic invasion that was mild and restricted to the lamina propria in a patient with a pT1b tumour. The outcome in the rest was excellent.
Conclusion:
Most pT1 cancers spread locally. Complete resection results in cure regardless of the scope of the operation done. The main determinant of prognosis is the presence of tumour at the resection margins. All pT1 cancers can therefore be regarded as early cancers of the gallbladder.