Aggressive Surgical Management of Gallbladder Cancer: Long-Term Results From a Retrospective Study of 315 Chinese Patients

Objective: To investigate the best surgical treatment for the gallbladder cancer patient. Summary of Background Data: Until now, aggressive surgery for advanced gallbladder cancer has been controversial. In this study, we analyzed gallbladder cancer patients' data retrospectively to find out which is the best surgical treatment for the patient. Methods: From 2009 to 2013, 315 cases of gallbladder carcinoma were identified. Data were analyzed retrospectively. The review included analysis of survival rate, postoperative complications, operative mortality rate, and correlation between local extent of the primary tumor and frequency of nodal metastases. Results: Postoperative complications occurred in 15 patients (6.2%). A total of 3% of patients who underwent a radical surgery procedure had complications, but in the extended radical surgery group, it was 9.8%. Operative mortality rate was 4.94%. No lymph node metastases were found in patients with T1 tumors. Nodal involvement in patients with T3 (55.22%) and T4 (82.50%) tumors was significantly higher than that in patients with T2 tumors (44.12%). In patients with stages I and II cancers, the radical resection group had a better survival rate than the simple cholecystectomy group. In patients with stage III cancer, the extended radical surgery group and radical surgery group showed better survival rates than others. In patients with stage IV cancer, the extended radical surgery group showed a 4% survival rate at 2 years, but others group had a 0% survival rate. Conclusions: Simple cholecystectomy may decrease the long survival rates in patients with stages I and II cancer. In more advanced stages, extended radical resection should be performed if R0 resections can be achieved.