Management of Incidentally Discovered Gallbladder Cancer
The management of incidentally discovered gallbladder cancer, identified either intra-operatively or post-operatively, is still hotly debated. Surgical management options for incidentally discovered gallbladder cancer include observation after simple cholecystectomy (open or laparoscopic) or radical surgical re-excision of the gallbladder fossa with hilar lymphadenectomy. Adjuvant therapy after diagnoses remains controversial and is often individualized. Evidence to date strongly favors radical re-excision in cases of T1a tumors with positive margins or lymph nodes and T1b-T3 tumors without evidence of distant nodal (N2) or metastatic (M1) disease. The role of adjuvant therapy appears to be one that complements definitive surgical resection and is advised for increased stage, residual disease after surgical resection (R1/R2 resection), and/or the presence of lymph node metastasis (N1 disease). Improved overall survival and disease-free recurrence has been demonstrated for radical surgical re-excision with consideration of adjuvant therapy for the aforementioned indications.
KeywordsGallbladder cancer Gall bladder adenocarcinoma Simple cholecystectomy Radical cholecystectomy Surgical re-excision Adjuvant therapy Cholecystectomy
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