Prognostic analysis of lymph node resection and liver resection for T1b and T2 gallbladder cancer: a multi-center retrospective study.

Background: Survival benefit of extended cholecystectomy including lymph node resection (LNR) and liver resection (LR) is still debating.

Methods: Patients pathologically diagnosed with T1b and T2 stage GBC in 6 medical centers from 2012 to 2022 were included and retrospectively analyzed. Clinical variables, including patient characteristics, overall survival (OS), disease-free survival (DFS), surgical approaches, and adjuvant treatments were collected. Propensity score-matching was performed to compare the survival outcomes.

Results: A total of 160 T1b/T2 GBC patients were included. 52 patients undergoing LNR were matched to 54 patients without LNR. After matching, LNR demonstrated significant survival benefit in OS (mOS 48.8 months vs not reached; p = 0.020) and DFS (mDFS 47.9 months vs 70.2 months; p = 0.038). Meanwhile, 61 patients undergoing LR were matched to 54 patients without LR. After matching, LR demonstrated no statistical difference in overall survival (mOS 68.2 months vs 78.5 months; p = 0.72) and disease-free survival (mDFS 67.1 months vs 42.6 months; p = 0.30).

Conclusions: Our results revealed that pathological T1b and T2 GBC patients benefit from radical cholecystectomy including lymph node resection and may not benefit from liver resection.