Oncologic Outcomes of Extended Lymphadenectomy without Liver Resection for T1/T2 Gallbladder Cancer

Abstract

Purpose: This study provides a standardized operative strategical algorithm that can be applied to patients with T1/T2 gallbladdercancer (GBC). Our aim was to determine the oncologic outcome of radical cholecystectomy with para-aortic lymph node dissectionwithout liver resection in T1/T2 GBC. Materials and Methods: From January 2005 to December 2017, 164 patients with GBC underwent operations by a single surgeonat Severance Hospital. A retrospective review was performed for 113 of these patients, who were pathologically determined to be instages T1 and T2 according to American Joint Committee on Cancer 7th guidelines. Results: Of the 113 patients, 109 underwent curative resection for T1/T2 GBC; four patients who underwent palliative operationswithout radical cholecystectomies were excluded from further analyses. For all T1b and T2 lesions, radical cholecystectomy withpara-aortic lymph node dissection was performed without liver resection. There were four GBC-related mortalities, and 5-yeardisease-specific survival was 97.0%. The median follow-up was 50 months (range: 5–145 months). In all T stages, the median wasnot reached for survival analysis. Five-year disease-specific survival for T1a, T1b, and T2 were 100%, 94.1%, and 97.1%, respectively. Five-year disease-free survival for T1a, T1b, and T2 were 100%, 87.0%, and 91.8%, respectively. Conclusion: Our results suggest that the current operative protocol can be applied to minimal invasive operations for GBC withsimilar oncologic outcomes as open approach. For T1/T2 GBC, radical cholecystectomy, including para-aortic lymph node dissection,can be performed safely with favorable oncologic outcomes.