Gallbladder cancer
ICD-10 C23 · ICD-11 2C13

Non-Metastatic Gallbladder Carcinoma: What to Do After Radical Surgery Targeting Clear Margins

This protocol addresses the treatment step that follows radical curative-intent surgery in patients with resectable gallbladder carcinoma and no metastatic spread.

Clinical scenarioGallbladder carcinoma with no evidence of metastatic spread, where the disease is considered resectable. When gallbladder cancer is diagnosed — whether through imaging in symptomatic patients or at presentation with jaundice — evaluation of resectability is the key factor. Surgery is the only modality with curative potential and the resectability decision should be made by a specialist hepatobiliary multidisciplinary tumour board.

Previous treatment stepThe preceding line is radical curative-intent surgery, with the goal of achieving resection with no tumour at the margin (R0). This includes resection of the relevant liver segments together with lymphadenectomy of the hepatoduodenal ligament, with further anatomical resection where tumour location requires it. Once this surgical phase has been completed, the question of systemic follow-on treatment arises.

Next treatment approachFollowing surgery, adjuvant chemotherapy is the recommended next step in this setting. The specific regimen, drug selection, and full structured guidance are available in the complete protocol below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.annonc.2022.10.506 View source ↗