Management of Gallbladder Squamous Cell Carcinoma Invading Muscular Layer

Staging and Classification

The tumor described is classified as T1b (tumor invades muscular layer) according to the TNM 2010 staging system for gallbladder cancer 1, 3

Extended cholecystectomy including en bloc hepatic resection and lymphadenectomy is the recommended management approach for a gallbladder with squamous cell carcinoma invading the muscular layer but not reaching the serosa (T1b N0) 1, 2
The procedure should include en bloc hepatic resection (gallbladder bed with 2cm margin of liver tissue) 1, 4
The procedure should include regional lymphadenectomy (nodes along cystic duct, common bile duct, hepatic artery, and portal vein) 1, 2
The procedure may include bile duct excision depending on involvement 2

Fluorouracil-based chemotherapy has been associated with survival benefit after non-curative resection 1, 5