IMS study offers guidelines to improve gallbladder cancer treatment

Varanasi: Researchers from the department of surgical oncology of Institute of Medical Sciences, BHU, have published a study titled 'Defining Surgical Excellence in Gallbladder Cancer: A Meta-Analysis Validating the 6-Node Threshold and Extended D2 Lymphadenectomy Across All T-Stages' in the European Journal of Surgical Oncology, enlisting surgical guidelines and improve clinical outcomes in gallbladder cancer, particularly in high-burden regions like northern India.

In collaboration with Health Technology Assessment in India (HTAIn) nodal centre, the study was led by Prof Manoj Pandey with contributions from team members, IMS-BHU. The analysis follows systematic review and meta-analysis methods, incorporating global data published between 1999 and 2025. The study, based on a comprehensive analysis of 27 international studies involving over 56,000 patients, establishes that removal of at least six lymph nodes is a critical surgical quality benchmark significantly associated with improved survival in gallbladder cancer. It further demonstrates that the survival benefit of lymphadenectomy is consistent across all disease stages (T1b-T4), while extended lymphadenectomy (D2), including retropancreatic and celiac nodes, provides superior outcomes in T2 and T3 disease.

The findings highlight that adequate lymph node removal not only improves staging accuracy but also reduces recurrence and enhances disease-free survival, thereby establishing lymphadenectomy as a key therapeutic component rather than merely a diagnostic procedure.
The study is important as gallbladder cancer is particularly prevalent in parts of India and often diagnosed at advanced stages. Surgical removal remains the only curative option, but the extent of surgery has long been debated. The study resolves a critical clinical question by demonstrating that lymphadenectomy is not just for staging but has a direct therapeutic benefit, improving both survival and disease control.

"Our findings provide a clear, evidence-based framework for surgeons worldwide. Adequate lymph node removal should be considered essential, not optional, in gallbladder cancer surgery. It is important that in cases of suspected carcinoma of the gallbladder, a patient seek expert surgical oncology opinion and surgery performed by a surgeon with expertise in complex radical surgeries and not by a general surgeon. As a good comprehensive surgery is the only thing that offers a chance for cure," said Prof Pandey.