T1b gallbladder cancer: is extended resection warranted?

Montserrat Chavez; Xabier de Aretxabala; Hector Losada; Norberto Portillo; Felipe Castillo; Luis Bustos; Ivan Roa

doi:10.1016/j.hpb.2024.12.018

T1b gallbladder cancer: is extended resection warranted?

HPB (Oxford). 2024 Dec 30:S1365-182X(24)02466-3. doi: 10.1016/j.hpb.2024.12.018. Online ahead of print.

Authors

Montserrat Chavez¹, Xabier de Aretxabala², Hector Losada³, Norberto Portillo³, Felipe Castillo⁴, Luis Bustos⁵, Ivan Roa⁶

Affiliations

¹ Department of Surgery, Padre Hurtado Hospital, Santiago, Chile; Department of Surgery, Universidad del Desarrollo, Santiago, Chile.
² Department of Surgery, Padre Hurtado Hospital, Santiago, Chile; Department of Surgery, Universidad del Desarrollo, Santiago, Chile; Surgical Unit, Clinica Alemana, Santiago, Chile. Electronic address: xdearetxabala@alemana.cl.
³ Department of Surgery, Universidad de la Frontera, Temuco, Chile; Surgical Unit, Hospital Hernan Henriquez, Temuco, Chile.
⁴ Department of Surgery, Padre Hurtado Hospital, Santiago, Chile; Department of Surgery, Universidad del Desarrollo, Santiago, Chile; Surgical Unit, Clinica Alemana, Santiago, Chile.
⁵ Department of Epidemiology, Universidad de la Frontera, Temuco, Chile.
⁶ Pathology Department, Clinica Alemana, Temuco, Chile.

PMID: 39824714
DOI: 10.1016/j.hpb.2024.12.018

Abstract

Background: Although the prognosis for gallbladder cancer (GBCA) improves with early diagnosis and aggressive surgical treatment, the management of patients with muscle layer invasion (T1b) remains controversial. This study aimed to analyze the optimal surgical approach for these patients.

Methods: A database was queried for patients with early T1b GBCA treated at four Chilean hospitals. Patients were prospectively treated and registered by the same surgical team at each hospital. Clinical outcomes, including survival rates according to the type of surgery, were analyzed.

Results: Between 1988 and 2023, 129 Chilean patients were pathologically diagnosed with T1b GBCA. Simple cholecystectomy (SC) was performed in 86 patients (66.7 %), while extended cholecystectomy (EC) was performed in 43 patients. The overall 5-year survival rate was 83 %, with no significant difference between SC and EC patients.

Conclusion: Simple cholecystectomy demonstrated survival rates comparable to extended cholecystectomy for patients with T1b GBCA. More extensive resections did not improve the prognosis.