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Role of Cholecystectomy and Lymph Node Dissection in Patients with T2 Gallbladder Cancer

Authors
 Dong Hyun Kim  ;  Sung Hoon Kim  ;  Gi Hong Choi  ;  Chang Moo Kang  ;  Kyung Sik Kim  ;  Jin Sub Choi  ;  Woo Jung Lee 
Citation
 World Journal of Surgery, Vol.37(11) : 2635-2640, 2013 
Journal Title
 World Journal of Surgery 
ISSN
 0364-2313 
Issue Date
2013
Abstract
BACKGROUND: Incidental findings of gallbladder cancer (GBCA) have dramatically increased as an initial presentation of the disease because of the expansion of laparoscopic cholecystectomy. However, the optimal management of T2 GBCA remains at issue. METHODS: We compared our 10-year experience with the consensus surgical strategy for T2 GBCA. Between January 2000 and December 2009, 70 patients at Severance Hospital, Yonsei University Health System, Seoul, Korea, underwent surgical treatment for GBCA stage T2. The medical records of 70 patients with T2 GBCA were retrospectively reviewed. RESULTS: Radical cholecystectomy was performed on only 32 (45.8 %) patients. In patients with T2 GBCA and positive lymph nodes (LN), the overall survival rate between cholecystectomy with LN dissection and radical cholecystectomy did not show a significant difference. Twenty patients experienced recurrence during the follow-up period. Among the 11 patients who underwent cholecystectomy with liver resection, only 2 (18.2 %) patients had an intrahepatic recurrence. Of the 9 patients who underwent cholecystectomy without liver resection, 3 (33.3 %) patients had an intrahepatic recurrence. However, recurrences at the gallbladder bed occurred only in one and two patients, respectively, and were not significantly different between the two groups. CONCLUSIONS: There was a large gap between clinical practice and treatment guidelines. Though relatively few patients enrolled in this study experienced recurrence, cholecystectomy and LN dissection without liver resection showed similar survival and recurrence patterns compared with those of radical cholecystectomy. To improve consistency between clinical practice and consensus guidelines, the role of limited resection for T2 lesions needs further evaluation.
Full Text
http://link.springer.com/article/10.1007%2Fs00268-013-2187-2
DOI
10.1007/s00268-013-2187-2
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
강창무(Kang, Chang Moo) ORCID logo https://orcid.org/0000-0002-5382-4658
김경식(Kim, Kyung Sik) ORCID logo https://orcid.org/0000-0001-9498-284X
김동현(Kim, Dong Hyun)
이우정(Lee, Woo Jung) ORCID logo https://orcid.org/0000-0001-9273-261X
최기홍(Choi, Gi Hong) ORCID logo https://orcid.org/0000-0002-1593-3773
최진섭(Choi, Jin Sub)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87848
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