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J.Jpn. Surg. Soc.. 122(2): 166-171, 2021
Gallbladder cancer (GBC) is a devastating disease, and the majority of the patients are diagnosed with advanced disease at initial presentation. Over the past decades, extended surgical procedures have been attempted to treat locally advanced GBC for increasing resectability. Refinements of surgical techniques and perioperative management have decreased operative morbidity and mortality, resulting in improved overall survival; however, a subset of patients who undergo such extended surgical resection may have noncurative resection and experience early recurrence. Currently, no clear definition of the boundary between resectable and unresectable disease exists, although recent advances in chemotherapy for unresectable biliary tract cancer have yielded substantial overall survival benefits. A new definition of borderline resectable GBC would clarify the imprecise continuum between technically resectable and unresectable disease, and a subset of patients with borderline disease may benefit from multidisciplinary treatment strategies combining surgical and nonsurgical treatment to improve overall survival.
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