Published online Sep 27, 2020. doi: 10.4254/wjh.v12.i9.641
Peer-review started: March 9, 2020
First decision: May 5, 2020
Revised: July 10, 2020
Accepted: July 18, 2020
Article in press: July 18, 2020
Published online: September 27, 2020
Processing time: 196 Days and 13.1 Hours
Gallbladder cancer (GBC) is the most common biliary malignancy with the worst prognosis, but aggressive surgeries may improve long-term survival.
We evaluated our own data along with a discussion of therapeutic strategies for GBC.
Nineteen GBC patients who underwent surgical treatment were enrolled in this study.
We retrospectively investigated our patients with incidentally or non-incidentally diagnosed GBC.
Suspicious or incidental GBCs at earlier stages showed excellent outcomes without the need for two-stage surgery. Lymph nodes (LNs) around the cystic duct were reliable sentinel nodes in suspicious/incidental GBCs. Extended lymphadenectomy and resection of the extrahepatic bile duct (EHBD) prevented metastases or recurrence in early-stage GBCs but not in advanced GBCs with metastatic LNs or invasion of the nerve plexus. All patients with positive surgical margins showed poor outcomes, and we may need to reconsider the indications for major hepatectomy, minimizing its use except when it is required to accomplish negative bile duct margins. There were significant differences in overall and disease-free survival between patients with stages ≤ IIB and ≥ IIIA disease. The median overall survival and disease-free survival were 1.66 and 0.79 years, respectively.
Outcomes for GBC patients remain unacceptable.
Improved therapeutic strategies should be considered for patients with advanced GBCs.