New trends in diagnosis and management of gallbladder carcinoma

Table 1 T classification in TNM system for gallbladder adenocarcinoma of AJCC 8^th edition

T	Invasion
Tis	In situ
T1a	Only lamina propria
T1b	Lamina propria and muscle layer
T2a	Perimuscular fibrous tissue on the side of the peritoneum
T2b	Perimuscular fibrous tissue on the side of the liver
T3	Serosa, and/or liver, and/or adjacent organs (stomach, duodenum, colon, pancreas, omentum, common bile duct)
T4	Hepatic artery or main portal vein or ≥ 2 adjacent organs

Table 2 TNM staging for gallbladder adenocarcinoma of American Joint Committee on Cancer 8^th edition

Stage	Parameters
0	Tis, N0, M0
I	T1, N0, M0
IIa	T2a, N0, M0
IIb	T2b, N0, M0
IIIa	T3, N0, M0
IIIb	T1-T3, N1, M0
IVa	T4, N0-N1, M0
IVb	Any T, N2, M0 or any T, any N, M1

M0: Without distant metastases; M1: Presence of distant metastases; N0: Negative lymph nodes; N1: Positive 1-3 regional lymph nodes; N2: Positive ≥ 4 regional lymph nodes; T: Tumor invasion.

Table 3 Predictive factors for favorable prognosis of gallbladder carcinoma

No.	Factor
1	Age ≤ 70 yr
2	Stage Tis, T1-T2
3	R0 resection
4	G1 cell differentiation
5	Absence of lymph node infiltration
6	Absence of perineural invasion
7	Distant tumor location (body, fundus)
8	Preoperative bilirubin ≤ 3 mg/dL
9	Absence of concurrent acute cholecystitis
10	Absence of postoperative infectious complications
11	Absence of early recurrence
12	Multimodality treatment