Radical resection improves survival for patients with pT(2) gallbladder carcinoma

Radical resection (wedge resection of the gallbladder bed and dissection of the hepatoduodenal ligament, portal, and celiac lymph nodes) has been repo rted to improve survival from pathologic T-2 gallbladder carcinoma (pT(2) G BCa; invasion through the muscularis without perforation of the serosa). We report our experience and the outcome of patients with pT(2) GBCa. Between 1989 and 2000 at Vanderbilt University Medical Center ten patients were fo und to have pT2 disease after cholecystectomy. The patients had an average age of 64 +/- 13 years and underwent either radical resection (n = 5) or no further surgical therapy (n = 5). Of the patients who underwent cholecyste ctomy only, one (20%) is still alive at 27 months and four (80%) died of re current GBCa between 6.5 and 21 months. For the patients who underwent radi cal resection all five are alive at 15 to 83 months with no recurrence. The proportion of patients surviving pT2 GBCa after radical resection was sign ificantly greater than with cholecystectomy alone (P < 0.05). The differenc e in length of survival between the two groups was also significant (P < 0. 05). Morbidity after radical resection was low (pancreatic leak in one pati ent), and there were no operative mortalities. Radical resection significan tly improved survival over cholecystectomy alone for patients with pT(2) GB Ca. The procedure has low morbidity and mortality rates. Therefore a radica l resection operation is indicated for patients with pT(2) GBCa.