T2 gallbladder carcinoma: Clinicopathological features and optimal surgical strategies

Abstract Purpose: For gallbladder carcinomas (GBCs), the only effective treatment is surgery. In this study, we aimed to determine the clinicopathologicalfeatures of T2 GBC and identify the optimal surgical strategies. Methods: This was a retrospectivestudy of 77 patients with histologically verified T2 subserosal GBC who underwent surgery at our institution between 1989 and 2021. Pathological data (tumor size, location, grade, lymph node status, and lymphovascular and perineural invasions) and demographic data were reviewed. The 5-year disease-specific survival (DSS) rates were determined and included in our analysis. Results: The 42 (55%) patients in our sample who were pathological invasion (PI)-positive had significantly lower 5-year DSS. PI was significantly correlated with lymph node metastasis but not with tumor location. Those with PI treated with radical cholecystectomies had better 5-year DSS rates than those treated with simple cholecystectomies (57% vs 25%, p = 0.04). However, different surgical procedures produced no significant differences in the 5-year DSS of PI-negative patients. Conclusions: PI-positive T2 GBC patients had poor prognoses and required radical cholecystectomy. However, PI-negative cases had low lymph node metastases rates and favorable prognoses. In these cases, simple cholecystectomy may be more appropriate.