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Pooling seven studies, muscle-invading gallbladder cancers on the liver side were about twice as likely to be fatal as those on the free side, yet the bigger operation did not clearly improve survival in either group.
Systematic review and random-effects meta-analysis of studies to September 2020: seven studies, 1,789 resected T2 gallbladder cancers. Overall survival was worse for T2b (hepatic side) than T2a: hazard ratio 2.141 (95 percent CI 1.140 to 4.023; I2 71.4 percent). Lymph node metastasis was 26.6 percent in T2a and 36.6 percent in T2b (odds ratio 2.164, 1.309 to 3.575). Extended and simple cholecystectomy showed no survival difference in T2a (odds ratio 0.802, 0.618 to 1.042) or T2b (0.820, 0.620 to 1.083). The authors call for large prospective studies to set evidence-based treatment for T2 disease.
The prognostic split is solid; the surgical consequence is not. Whether T2a tumours can safely skip liver resection, and whether T2b tumours gain from it, is a randomised or prospective-registry question that nobody has yet run.
Shares A trial of sparing the liver resection in peritoneal-side (T2a) gallbladder cancer, T2a versus T2b gallbladder cancer (peritoneal side versus hepatic side), Radical (extended) cholecystectomy, Gallbladder cancer and the tag gallbladder-evidence.
Shares A trial of sparing the liver resection in peritoneal-side (T2a) gallbladder cancer, T2a versus T2b gallbladder cancer (peritoneal side versus hepatic side), Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares T2a versus T2b gallbladder cancer (peritoneal side versus hepatic side), Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares Radical (extended) cholecystectomy, Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.
Shares T2a versus T2b gallbladder cancer (peritoneal side versus hepatic side), Gallbladder cancer roadmap: from a chance finding at gallstone surgery to a disease with its own trials, Gallbladder cancer and the tag gallbladder-evidence.