Selection of surgical methods for T1 and T2 gallbladder carcinoma

doi:10.3877/cma.j.issn.2095-3232.2021.01.006

Chinese Journal of Hepatic Surgery(Electronic Edition) ›› 2021, Vol. 10 ›› Issue (01): 24-28. doi: 10.3877/cma.j.issn.2095-3232.2021.01.006

Special Issue: ；

• Clinical Research • Previous Articles Next Articles

Selection of surgical methods for T1 and T2 gallbladder carcinoma

Da Teng¹, Peng Liu², Zhimin Geng³, Wenlong Zhai⁴, Yinghe Qiu⁵, Tianqiang Song⁶, Yu He⁷, Jingdong Li⁸, Shengping Li⁹, Zhaohui Tang¹⁰, Peng Gong²^,^†()

^1. Department of Hepatobiliary Surgery, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
^2. Department of General Surgery, Shenzhen University General Hospital, Shenzhen 518055, China
^3. Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
^4. Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
^5. Department Ⅰ of Biliary, Eastern Hepatobiliary Surgery Hospital, the Second Military Medical University, Shanghai 200438, China
^6. Department of Hepatobiliary Oncology, Tianjin Medical University Cancer Hospital, Tianjin 300060, China
^7. Hepatobiliary Surgery Institute, Southwest Hospital of Army Medical University, Chongqing 400038, China
^8. Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China
^9. Department of Hepatobiliary Surgery, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
^10. Department of General Surgery, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China

Received:2020-10-20 Online:2021-02-10 Published:2021-02-10
Contact: Peng Gong

Abstract

Abstract:

Objective

To explore the surgical approaches for T1 and T2 gallbladder carcinoma.

Methods

Clinical data of 139 patients with gallbladder carcinoma treated by surgery in 8 medical centers in China from January 2010 to December 2018 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 48 patients were male and 91 female, aged from 30 to 88 years old with a median of 64 years old. 67 cases were classified in stage T1 and 72 cases in stage T2. The surgical procedures included simple cholecystectomy (SC), SC combined with lymphadenectomy of hepatoduodenal ligament (SC+L), and radical resection of gallbladder carcinoma (RC). RC1 was defined as cholecystectomy with wedge resection of liver tissues 2 cm from the gallbladder bed, and RC2 referred to cholecystectomy with resection of segment Ⅳb and Ⅴ. Survival analysis was performed by Kaplan-Meier method and Log-rank test.

Results

The median survival time of stage T1a patients in SC, RC1 group was 64 and 59 months, respectively. No significant difference was observed between two groups (χ2=0.088, P>0.05). The median postoperative survival time of patients with stage T1b gallbladder carcinoma in SC, SC+L, RC1 group was 40, 60 and 61 months, respectively. The survival of patients in SC+L and RC1 groups were significantly better than that in SC group (χ2=4.092, 4.364; P<0.05), whereas no significant difference was noted between the SC+L and RC1 groups (χ2=0.698, P>0.05). The median survival time of patients with stage T2a gallbladder cancer in RC1, RC2 was both 48 months, and no significant difference was observed between two groups (χ2= 0.219, P>0.05). The median survival time of patients with stage T2b gallbladder carcinoma in RC1, RC2 group was 33 and 47 months, respectively. The survival in RC2 group was better than that in RC1 group (χ2=4.370, P<0.05).

Conclusions

SC is recommended for patients with stage T1a gallbladder carcinoma, SC+L for stage T1b and wedge resection can be performed when necessary. RC1 is suitable for stage T2a patients and RC2 for stage T2b patients.

Key words: Gallbladder neoplasms, Surgical procedures, operative, TNM stages

Da Teng, Peng Liu, Zhimin Geng, Wenlong Zhai, Yinghe Qiu, Tianqiang Song, Yu He, Jingdong Li, Shengping Li, Zhaohui Tang, Peng Gong. Selection of surgical methods for T1 and T2 gallbladder carcinoma[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2021, 10(01): 24-28.

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