Long-term effect of liver resection in T2 and T3 gallbladder cancer

Background

Since the 8th edition of the American Joint Committee on Cancer (AJCC) staging system, few studies have examined long-term outcomes for gallbladder cancer.

Methods

A retrospective analysis was conducted in March 2024 on 180 consecutive patients with T2 or T3 gallbladder carcinoma who underwent surgery between January 2010 and December 2019. Radical resection was defined as liver resection with the procurement of at least four lymph nodes.

Results

The 5-year overall survival (OS) rate for patients who underwent liver resection was 43.8 %, compared to 26.7 % for those who did not (p = 0.047). The 5-year OS for patients with fewer than four procured lymph nodes was 33.1 %, whereas it was 49.9 % for those with four or more lymph nodes (p = 0.052). Following radical resection, the 5-year OS rate was 52.5 %, compared to 31.7 % for those who did not undergo radical resection (p = 0.014). In subgroup analysis of T2a and T3 gallbladder cancer, the 5-year OS rates for patients who underwent liver resection were 72.0 % and 15.5 %, respectively, compared to 43.8 % and 0.0 % for those who did not undergo liver resection (p < 0.05). Multivariate analysis identified T stage, perineural invasion, elevated CA 19-9 levels, and radical resection as independent prognostic factors for OS.

Conclusions

Radical surgery, including appropriate hepatic resection and lymph node dissection, is essential for improving long-term prognosis in T2a, T2b, and T3 gallbladder cancers. AJCC T stage, perineural invasion, elevated CA 19-9 levels, and radical resection were independently associated with OS.