Dr Eilard and colleagues from Sweden evaluated existing evidence regarding surgical treatments for gallbladder cancer in a Health Technology Assessment.
The researchers specifically evaluated 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.
The team performed a systematic literature search in PubMed, Embase, and the Cochrane Library from 2015 to 2016.
There were 2 authors that independently screened titles, abstracts, and full-text articles.
|42 observational studies, and 7 case series were identified|
|Scandanavian Journal of Gastroenterology|
The certainty of evidence was evaluated according to GRADE.
The researchers identified 42 observational studies, and 7 case series.
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.
The team observed a survival benefit in patients with stage T1b or higher with lymph node resection, most evident in stage T2, but the certainty of evidence was low.
It is uncertain whether routine bile duct resections improve overall survival in patients with gallbladder cancer stage T2–T4.
Dr Eilard's team concludes, "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."