Early gallbladder carcinoma does not warrant radical resection

Background: This study was designed to address whether gallbladder cancer i nvading the muscle layer (stage pT(1b)) is a local disease and whether radi cal resection is necessary. Methods: A retrospective analysis of 25 patients with pT(1b) gallbladder tu mours, 13 of whom underwent simple cholecystectomy and 12 radical resection with regional lymph node dissection, was performed. A total of 147 regiona l lymph nodes was examined for metastasis, The median follow-up time was 95 months. Results: No patient had blood vessel or perineural invasion on histology. L ymphatic vessel invasion was seen in one patient, Both overt metastasis and micrometastases were absent in all lymph nodes examined. Overall 10-year s urvival was 87 per cent. The outcome after simple cholecystectomy was compa rable to that after radical resection (P = 0.16). Two patients who underwen t radical resection died from tumour relapse in distant sites, Conclusion: Most pT(1b) gallbladder carcinomas spread only locally. Additio nal radical resection is not necessary when the depth of invasion of gallbl adder carcinoma is limited to the muscle layer after simple cholecystectomy .