Surgical treatment for gallbladder cancer – a systematic literature review
- 9 February 2017
- journal article
- review article
- Published by Informa UK Limited in Scandinavian Journal of Gastroenterology
- Vol. 52 (5), 505-514
- https://doi.org/10.1080/00365521.2017.1284895
Abstract
Objective: To evaluate existing evidence regarding surgical treatments for gallbladder cancer in a Health Technology Assessment. A specific aim was to evaluate whether extended surgery regarding liver, lymph nodes, bile duct, and adjacent organs compared with cholecystectomy alone in the adult patient with gallbladder cancer in early and late stages implies improved survival. Methods: In April 2015 and updated in June 2016, a systematic literature search was conducted in PubMed, Embase, and the Cochrane Library. Two authors independently screened titles, abstracts, and full-text articles. The certainty of evidence was evaluated according to GRADE. Main results: Forty-four observational studies (non-randomised, controlled studies) and seven case series were included. Radical resection, including liver and lymph node resection, compared with cholecystectomy alone showed significantly better survival for patients with stages T1b and above. All studies had serious study limitations and the certainty of evidence was very low (GRADE circle plus(ooo)). A survival benefit seen in patients with stage T1b or higher with lymph node resection, was most evident in stage T2, but the certainty of evidence was low (GRADE circle plus circle plus(oo)). It is uncertain whether routine bile duct resections improve overall survival in patients with gallbladder cancer stage T2-T4 (GRADE circle plus(ooo)). Conclusion: Data indicate that prognosis can be improved if liver resection and lymph node resection is performed in patients with tumour stage T1b or higher. There is no evidence supporting resection of the bile duct or adjacent organs if it is not necessary in order to achieve radicality.Keywords
Funding Information
- HTA –
This publication has 68 references indexed in Scilit:
- Impact of lymph node ratio as a valuable prognostic factor in gallbladder carcinoma, focusing on stage IIIB gallbladder carcinomaJournal of the Korean Surgical Society, 2013
- Analysis of the Relationships between Clinicopathologic Factors and Survival in Gallbladder Cancer following Surgical Resection with Curative IntentPLOS ONE, 2012
- Surgical Outcomes of Minor Hepatectomy for Locally Advanced Gallbladder CarcinomaHepatogastroenterology, 2012
- Regional lymphadenectomy for gallbladder cancer: Rational extent, technical details, and patient outcomesWorld Journal of Gastroenterology, 2012
- Outcomes of Radical Surgery for Gallbladder Cancer Patients with Lymphatic MetastasesJapanese Journal of Clinical Oncology, 2011
- Should the extrahepatic bile duct be resected or preserved in R0 radical surgery for advanced gallbladder carcinoma? Results of a Japanese Society of Biliary Surgery Survey: A multicenter studySurgery Today, 2009
- Immediate re-resection of T1 incidental gallbladder carcinomas: a survival analysis of the German RegistrySurgical Endoscopy, 2008
- S3-Leitlinie der Deutschen Gesellschaft für Verdauungs- und Stoffwechselkrankheiten und der Deutschen Gesellschaft für Viszeralchirurgie zur Diagnostik und Behandlung von GallensteinenZeitschrift für Gastroenterologie, 2007
- The surgical management of incidental gallbladder carcinomaEuropean Journal of Surgical Oncology, 2005
- Evaluation of aggressive surgical treatment for advanced carcinoma of the gallbladderJournal of Hepato-Biliary-Pancreatic Surgery, 2003