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World J Gastroenterol. Oct 14, 2011; 17(38): 4347-4348
Published online Oct 14, 2011. doi: 10.3748/wjg.v17.i38.4347
Published online Oct 14, 2011. doi: 10.3748/wjg.v17.i38.4347
Regional lymphadenectomy strongly recommended in T1b gallbladder cancer
Ulrich Klaus Fetzner, Arnulf H Hölscher, Dirk L Stippel, Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, D-50937 Cologne, Germany
Author contributions: Fetzner UK, Hölscher AH and Stippel DL all together, contributed equally to this work.
Correspondence to: Dr. Ulrich Klaus Fetzner, Department of General, Visceral and Cancer Surgery, University Hospital of Cologne, Kerpener Strasse 62, D-50937 Cologne, Germany. ulrich.fetzner@uk-koeln.de
Telephone: +49-221-4784801 Fax: +49-221-4784843
Received: March 3, 2011
Revised: June 24, 2011
Accepted: July 1, 2011
Published online: October 14, 2011
Revised: June 24, 2011
Accepted: July 1, 2011
Published online: October 14, 2011
Abstract
This article discusses the adequate treatment of early gallbladder cancer (T1a, T1b) and is based on published studies extending over nearly 3 decades. Randomized studies and meta analyses comparing different surgical treatments do not exist. The literature shows that in up to 20% of patients lymph node metastasis are found in T1b gallbladder cancer. Due to high malignancy with early angiolymphatic spread and resistance to chemotherapy and radiation on the one hand, and the relative low operative risk of extended cholecystectomy (cholecystectomy and regional lymphadenectomy) on the other hand, we believe that this procedure is mandatory in early gallbladder cancer.