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T1b gallbladder cancer: is extended resection warranted?
Montserrat Chavez1, Xabier de Aretxabala2, Hector Losada3
1Department of Surgery, Padre Hurtado Hospital, Santiago, Chile; Department of Surgery, Universidad del Desarrollo, Santiago, Chile.
Summary
For gallbladder cancer (GBCA) with muscle layer invasion (T1b), simple cholecystectomy shows survival rates comparable to extended cholecystectomy. Aggressive surgery does not appear to improve prognosis in these early-stage cases.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Gallbladder cancer (GBCA) management is challenging, especially for T1b stage with muscle layer invasion.
- Early diagnosis and aggressive treatment improve prognosis, but optimal surgical approach for T1b GBCA is debated.
Purpose of the Study:
- To determine the optimal surgical strategy for T1b gallbladder cancer.
- To compare survival outcomes between simple cholecystectomy and extended cholecystectomy in T1b GBCA patients.
Main Methods:
- Retrospective analysis of 129 T1b GBCA patients from four Chilean hospitals (1988-2023).
- Comparison of clinical outcomes, focusing on survival rates, between patients undergoing simple cholecystectomy (SC) and extended cholecystectomy (EC).
Main Results:
- 129 patients diagnosed with T1b GBCA; 86 (66.7%) had SC, 43 (33.3%) had EC.
- Overall 5-year survival rate was 83% with no significant difference between SC and EC groups.
- More extensive resections (EC) did not yield improved survival compared to SC.
Conclusions:
- Simple cholecystectomy is a viable surgical option for T1b gallbladder cancer.
- Extended cholecystectomy does not offer a survival advantage over simple cholecystectomy for T1b GBCA.
- Current findings suggest that less extensive surgery may be sufficient for early-stage T1b GBCA.
