High Complication Rates Favor Caution in Surgery for Advanced Gallbladder Cancer: International Study Insights

Recent research highlights the risks associated with aggressive surgical approaches for treating advanced gallbladder cancer (GBC). Led by Boston University School of Medicine and involving data from over 1,000 patients across 17 hospitals in seven different countries, the study scrutinized the outcomes of major surgeries, particularly in patients with T3 and T4 tumors. These advanced stages often involve invasion into nearby organs or distant spread, prompting complex surgical strategies such as extensive liver resection, removal of adjacent organs like the stomach, duodenum, colon, or vascular structures, combined with chemotherapy or radiotherapy.

Despite existing guidelines, the optimal surgical extent for advanced GBC remains controversial, primarily due to the limited effectiveness of systemic chemotherapy and the high risk of postoperative complications. The study revealed that aggressive procedures, especially those involving the removal of tumor extensions beyond the primary site (OER), resulted in increased morbidity and did not significantly improve survival for T4 patients, who had more invasive disease.

Authors suggest that a more personalized treatment approach, considering specific risk factors such as jaundice or lymph node involvement, can lead to better outcomes. They advocate for careful patient selection for major surgery following systemic therapy, emphasizing that sometimes less aggressive interventions might be more beneficial in avoiding harm without compromising survival.

This research underscores the importance of individualized treatment planning and international collaboration to improve management strategies for this aggressive and understudied disease. The findings call for caution and further refinement of surgical criteria to enhance patient safety and quality of life.

Source: https://medicalxpress.com/news/2025-06-aggressive-surgery-advanced-gallbladder-cancer.html