Simple Cholecystectomy Vs. Radical Resection For Stage Ⅱ Gallbladder Cancer: A Meta-analysis

Objective: To analyze the 1-, 3-, 5-year survival rate and the tumor recurrence rate in patients with gallbladder cancer which has invaded the muscularis(stage Ⅱ) after simple cholecystectomy(SC) and radical resection(RR), and discuss the importance of radical resection in the treatment of this stage of gallbladder cancer.Methods: A literature search was conducted using the PubMed, Embase, Chinese National Knowledge Infrastructure and Wanfang databases from inception to February 2016. Quality assessment was conducted in each of the available studies by using the validated Newcastle-Ottawa Quality Assessment Scale(NOS) for cohort and case-control studies. The odds ratio(OR) and its 95% confidence interval(95%CI) were employed to estimated effect size. All statistical analyses were carried out using RevMan 5.2 software.Results: A total of 15 studies encompassing 424 patients meeting the search criteria were included. Pooled analyses revealed that comparing to simple cholecystectomy, radical resection can significantly increase the 1-, 3-, 5-year survival rate in patients with stage Ⅱ gallbladder cancer(OR=3.28, 95%CI 1.83-5.89, P<0.0001; OR=2.52, 95%CI 1.49-4.28, P=0.0006; OR=3.19, 95%CI 1.85-5.51, P<0.0001), and patients after radical resection have a lower tumor recurrence rate(OR=0.30,95%CI 0.11-0.80,P=0.02, significantly).Conclusion: The short- and long-term survival rate of patients with stage Ⅱ gallbladder cancer following radical resection are obviously higher than that of patients receiving simple cholecystectomy, and the tumor recurrence rate is obviously lower.