ScholarWorks@성균관대학교

초록

Background:The optimal surgical extent for T1 and T2 gallbladder (GB) cancer remains debated. This study aimed to evaluate the impact of lymph node (LN) dissection and liver resection on survival outcomes in T1 and T2 GB cancer.Methods:From 2010 to 2018, a retrospective analysis was conducted on 419 patients with pathologically confirmed T1 and T2 GB cancer who underwent curative surgery at a tertiary institution. Patients with other histologies, concurrent other organ resection, or incomplete data were excluded. LN dissection was defined as the removal of LNs >= 6. Survival outcomes were analyzed based on LN dissection and liver resection.Results:The cohort included 118 T1 and 241 T2 GB cancer patients. In T1 GB cancer, 5-year survival rate (5YSR) was similar between patients with and without LN dissection (87.0% vs. 86.6%, p = 0.208). Subgroup analyses of T1a and T1b showed no significant impact (p = 0.191 and p = 0.841). Multivariate analysis indicated that LN dissection was not associated with overall survival (hazard ratio 1.504, p = 0.534). In T2 GB cancer, 5YSR was similar between radical cholecystectomy and simple cholecystectomy with LN dissection (72.3% vs. 68.8%, p = 0.131). Subgroup analysis showed no significant difference in T2a (p = 0.180). Multivariate analysis confirmed simple cholecystectomy with LN dissection was comparable to radical cholecystectomy (hazard ratio 1.009, p = 0.983).Conclusion:Simple cholecystectomy is adequate for T1 GB cancer, regardless of LN dissection. For T2 GB cancer, simple cholecystectomy with LN dissection can be performed without liver resection in selected patients, particularly in T2a, provided adequate LN dissection is achieved.

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