Surgical treatment of gallbladder cancer

Sternby Eilard M, Cahlin C, Lundgren L, Sandström P, Samuelsson O, Svanberg T, Wikberg-Adania U, Strandell A
Record ID 32018011365
English
Authors' objectives: Background Gallbladder cancer is an aggressive cancer with high mortality. The severity of cancer is staged by the TNM-system. Stage T1 is the least and T4 is the most advanced stage of the primary tumour. In advanced stages, surgery is often not possible due to spread into the liver hilum, other organs or lymph nodes. Even in cases of radical surgery recurrence and mortality rates are high. Early stages of gallbladder cancer are often incidentally diagnosed in conjunction with cholecystectomy due to gallstone disease. Radical surgery is the only potentially curative treatment. However, the extent of surgery is a matter of debate. In the very early stages (T1a) simple cholecystectomy seems to be radical enough, but there has been a discussion whether this applies also to when the cancer has engaged also the smooth muscle layer (T1b). Objective To evaluate whether extended surgery compared with cholecystectomy alone in the adult patient with gallbladder cancer in early and late stages lead to improved survival.
Authors' results and conclusions: Gallbladder cancer is a disease with high mortality. Data indicate that the prognosis can be improved if liver resection and lymph node resection is performed in patients with the early stages (T1b and T2) of gallbladder cancer. Morbidity is likely to increase with extensive surgery. The uncertain riskbenefit balance constitutes a difficult ethical dilemma, and the effects on health-related quality of life remains to be elucidated.
Details
Project Status: Completed
Year Published: 2016
URL for published report: https://mellanarkiv-offentlig.vgregion.se/alfresco/s/archive/stream/public/v1/source/available/sofia/su4372-1728378332-324/native/2016_89%20HTA-rapport%20Surgical%20treatment%20of%20gallbladder%20cancer.pdf
English language abstract: An English language summary is available
Publication Type: Full HTA
MeSH Terms
  • Gallbladder Neoplasms
  • Cholecystectomy
Keywords
  • Extended surgery
Contact
Organisation Name: The Regional Health Technology Assessment Centre
Contact Address: The Regional Health Technology Assessment Centre, Region Vastra Gotaland, HTA-centrum, Roda Straket 8, Sahlgrenska Universitetssjukhuset, 413 45 GOTHENBORG, Sweden
Contact Name: hta-centrum@vgregion.se
Contact Email: hta-centrum@vgregion.se
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