Original Article
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©2011 Baishideng Publishing Group Co. , Limited. All rights reserved.
World J Gastroenterol. Jan 14, 2011; 17(2): 174-180
Published online Jan 14, 2011. doi: 10.3748/wjg.v17.i2.174
Table 1 Characteristics of included studies on surgical treatment of patients with T1 gallbladder cancer
Authors Yr No. of patients Primary outcome Secondary outcome 3 YSR 5 YSR Morbidity Mortality Recurrence Ogura et al [13 ] 1991 3661 NS Shirai et al [26 ] 1992 89 NS NS NS Ouchi et al [11 ] 1994 15 NS NS Chijiiwa et al [28 ] 1994 5 NS NS de Aretxabala et al [14 ] 1997 24 NS NS NS Mori et al [22 ] 1997 9 NS NS NS Benoist et al [1 ] 1998 362 Z'graggen et al [29 ] 1998 9 NS NS Shimada et al [9 ] 2000 17 NS Suzuki et al [30 ] 2000 25 NS NS Wakai et al [6 ] 2001 25 NS NS Puhalla et al [24 ] 2002 9 NS Wagholikar et al [7 ] 2002 14 NS NS Kim et al [17 ] 2002 19 NS NS Ouchi et al [18 ] 2002 2343 NS NS Wakai et al [10 ] 2002 15 NS NS Cucinotta et al [4 ] 2005 12 NS NS NS Yildirim et al [15 ] 2005 13 Eguchi et al [31 ] 2005 12 NS NS NS Sun et al [19 ] 2005 15 NS NS Otero et al [32 ] 2006 51 NS NS Yagi et al [8 ] 2006 13 NS NS Chan et al [12 ] 2006 33 NS NS NS Cangemi et al [27 ] 2006 15 NS Kang et al [16 ] 2007 11 NS You et al [3 ] 2008 52 NS Kwon et al [20 ] 2008 20 NS NS Kohya et al [21 ] 2008 15 NS NS NS Goetze et al [5 ] 2008 934 NS NS
Table 2 Surgical procedures for mucosa and T1b gallbladder cancer n (%)
T1a (n = 706) T1b (n = 560) P valueTotal (n = 1266) Simple cholecystectomy 590 (83.6) 375 (67.0) < 0.01 965 (76.2) Open cholecystectomy 321 (54.4) 286 (76.3) < 0.01 607 (62.9) Laparoscopic cholecystectomy 269 (45.6) 89 (23.7) 358 (37.1) Extended cholecystectomy 110 (15.6) 168 (30.0) < 0.01 278 (22.0) 2nd operation 16 (14.5) 43 (25.6) 59 (21.2) Major hepatectomy 6 (0.8) 16 (2.9) NS 22 (1.7) Pancreatoduodenctomy 0 1 (0.2) NS 1
Table 3 Lymph node metastasis of T1 gallbladder cancer n (%)
T1a (n = 280) T1b (n = 276) P valueTotal (n = 556) Lymphovascular invasion 7 (2.5) 33 (12.0) < 0.01 40 (7.2) Perineural invasion 1 (0.4) 7 (2.5) NS 8 (1.4) Lymph node metastasis 5 (1.8) 30 (10.9) < 0.01 35 (6.3)
Table 4 Studies reporting lymph node metastasis of T1 gallbladder cancer n (%)
T1a T1b Odds ratio 95% CI Goetze et al [5 ] 0/21 1/72 (1.4) 1.296 1.159-1.448 Yildirim et al [15 ] 0/5 1/8 (12.5) 1.714 1.063-2.765 You et al [3 ] 0/27 2/25 (8.0) 2.174 1.610-2.935 Kim et al [17 ] 0/10 1/9 (11.1) 2.250 1.342-3.771 Ogura et al [13 ] 5/201 (2.5) 25/165 (15.2) 7.000 2.616-18.733
Table 5 Studies reporting recurrence cases of T1 gallbladder cancer n (%)
T1a T1b Odds ratio 95% CI You et al [3 ] 1/27 (3.7) 0/25 0.510 0.39-0.67 Shirai et al [26 ] 2/78 (2.6) 0/11 0.874 0.81-0.95 Wakai et al [10 ] 1/13 (7.7) 0/2 0.923 0.79-1.08 Z'graggen et al [29 ] 0/3 1/6 (16.7) 1.200 0.84-1.72 Wagholikar et al [7 ] 0/2 5/12 (41.7) 1.286 0.91-1.82 Goetze et al [5 ] 0/21 14/72 (19.4) 1.362 1.19-1.56 Cangemi et al [27 ] 0/4 5/11 (45.4) 1.667 1.01-2.77 Kim et al [17 ] 0/10 1/9 (11.1) 2.250 1.34-3.77 Chan et al [12 ] 1/14 (7.1) 3/19 (15.8) 2.438 0.23-26.29 Otero et al [32 ] 0/25 9/26 (34.6) 2.471 1.71-3.57 Ouchi et al [11 ] 1/8 (12.5) 3/7 (42.9) 5.250 0.40-68.94 Ouchi et al [18 ] 1/167 (0.6) 3/67 (4.5) 7.781 0.79-76.19 Cucinotta et al [4 ] 1/5 (20) 6/7 (85.7) 24.000 1.14-505.2 Wakai et al [6 ] 0 2/25 (8.0)
Table 6 Recurrence cases of T1a gallbladder cancer after surgical treatment (n = 8)
Operation Time of recurrence (mo)/site Survival after op (mo) Shirai et al [26 ] NA1 NA/CBD 76 NA1 NA/CBD 66 Ouchi et al [11 ] Simple cholecystectomy NA/CBD 45 Ouchi et al [18 ] Laparoscopic cholecystectomy2 NA/NA NA Wakai et al [10 ] Laparoscopic cholecystectomy NA/P. seeding 52 Cucinotta et al [4 ] Laparoscopic cholecystectomy 7/Port site 20 Chan et al [12 ] Laparoscopic cholecystectomy 48.3/liver, lung 51 You et al [3 ] Laparoscopic cholecystectomy 3/CBD 19
Table 7 Recurrence pattern of T1b gallbladder cancer after surgical treatment n (%)
Simple cholecystectomy (n = 375) Extended cholecystectomy (n = 185) Loco-regional recurrence 12 (50.0) CBD 3 (6.4) Lymph node 5 (10.6) Port site 4 (8.5) Systemic recurrence 12 (50.0) 3 (60) Liver 7 (14.9) 2 (40) Peritoneal seeding 4 (8.5) Lung 1 (2.0) 1 (20) Unknown 23 (48.9) 2 (40) Totalb 47 (12.5) 5 (2.7)
Table 8 Five-year survival rates of patients with T1a and T1b gallbladder cancer after surgical treatment
N 5 YSR (%) T1 (T1a/T1b) T1a (SC/EC) T1b (SC/EC) T1 (SC/EC) Benoist et al [1 ] 361 (13/23) 45 44 44 You et al [3 ] 52 (27/25) 96.3 96 96.2 de Aretxabala et al [14 ] 24 (11/13) 100 75 75 Kang et al [16 ] 11 (3/8) 100 100 100 Sun et al [19 ] 15 (10/5) 100 100 100 Kwon et al [20 ] 20 (18/2) 100 100 100 Kohya et al [21 ] 15 (8/7) 100 100 100 Yildirim et al [15 ] 13 (5/8) 100 (100/100) 80 (50/100) 90 Kim et al [17 ] 19 (10/9) 100 (100/100) 100 (100/100) 100 Ouchi et al [11 ] 15 (8/7) (71/100) (42/100) Cangemi et al [27 ] 15 (4/11) 100 (37.5/100) Ogura et al [13 ] 366 (201/165) 82.6 72.5 Ouchi et al [18 ] 234 (167/67) 99 95 Otero et al [32 ] 51 (25/26) 70 Goetze et al [5 ] 93 (21/72) (42/79) Wakai et al [6 ] 25 (0/25) 87 (100/75) Wagholikar et al [7 ] 14 (2/12) 68 Shimada et al [9 ] 17 (10/7) 86.7 Eguchi et al [31 ] 25 (19/6) 92 Wakai et al [10 ] 15 (13/2) (90/100) Yagi et al [8 ] 13 (12/1) 100
Table 9 Five-year survival rates of patients with T1b gallbladder cancer after different surgical procedures
N (SC/EC) 5 YSR (%) P valueSC EC Wakai et al [6 ] 25 (17/8) 100 75 NS Kim et al [17 ] 9 (6/3) 100 100 NS Yildirim et al [15 ] 8 (5/3) 50 100 NS Ouchi et al [11 ] 7 (5/2) 42 100 < 0.05 Cangemi et al [27 ] 11 (8/3) 37.5 100 < 0.01 Goetze et al [5 ] 72 (49/23) 42 79 0.03
Table 10 Clinical outcome of laparoscopic cholecystectomy for T1a and T1b gallbladder cancer
N Recurrence 5 YSR (%) T1a T1b T1a T1b T1a T1b Mori et al [22 ] 7 2 0 0 Kim et al [17 ] 9 6 0 1 (port site) 100 100 Sun et al [19 ] 10 5 0 0 100 100 Eguchi et al [31 ] 13 5 0 0 100 100 Kwon et al [20 ] 18 2 0 0 100 100 Ouchi et al [18 ] 167 67 11 31 99 95