Benefit of extended radical surgery for incidental gallbladder carcinoma

We aimed to define the benefit of extended radical surgery for incidental gallbladder carcinoma (IGC), the most appropriate treatment for which remains controversial.

We analyzed retrospectively the management strategies and prognoses of 28 patients with IGC treated in our hospital.

After initial cholecystectomy, 10, 5, and 13 of the 28 patients were found to have T1a (m), T1b (mp), and T2 (ss) disease, respectively. The patients with T1a disease (T1a group) had a good prognosis; however, 9 of the 18 patients with T1b or T2 disease required additional S4a + 5 segmentectomy of the liver and bile duct resection (extended radical surgery; re-resected group), while 9 did not undergo additional treatment because of their poor general condition (no-treatment group). The re-resected group had a favorable prognosis, with an 88.9% 5-year disease-specific survival (DSS) rate, which was significantly better than that of the non-treatment group (30.5%, p = 0.015) and comparable to that of the T1a group (90.0%, p = 0.97). Examination of the re-resected specimens revealed residual disease in 44% (4/9).

Additional extended radical surgery improved the prognosis of patients with IGC, suggesting that there is curative potential in most cases.