Published data on survival of T2 gallbladder carcinoma (GBC) from different countries show a wide range of 5-year survival rates from 30–> 70%. Recently, studies have demonstrated substantial variation between countries in terms of their approach to sampling gallbladders, and furthermore, that pathologists from different continents apply highly variable criteria in determining stage of invasion in this organ. These findings raised the question of whether these variations in pathologic evaluation could account for the vastly different survival rates of T2 GBC reported in the literature. In this study, survival of 316 GBCs from three countries (Chile n = 137, South Korea n = 105, USA n = 74), all adequately sampled (with a minimum of five tumor sections examined) and histopathologically verified as pT2 (after consensus examination by expert pathologists from three continents), was analyzed. Chilean patients had a significantly worse prognosis based on 5-year all-cause mortality (HR: 1.89, 95% CI: 1.27–2.83, p = 0.002) and disease-specific mortality (HR: 2.41, 95% CI: 1.51–3.84, p < 0.001), compared to their South Korean counterparts, even when controlled for age and sex. Comparing the USA to South Korea, the survival differences in all-cause mortality (HR: 1.75, 95% CI: 1.12–2.75, p = 0.015) and disease-specific mortality (HR: 1.94, 95% CI: 1.14–3.31, p = 0.015) were also pronounced. The 3-year disease-specific survival rates in South Korea, the USA, and Chile were 75%, 65%, and 55%, respectively, the 5-year disease-specific survival rates were 60%, 50%, and 50%, respectively, and the overall 5-year survival rates were 55%, 45%, and 35%, respectively. In conclusion, the survival of true T2 GBC in properly classified cases is neither as good nor as bad as previously documented in the literature and shows notable geographic differences even in well-sampled cases with consensus histopathologic criteria. Future studies should focus on other potential reasons including biologic, etiopathogenetic, management-related, populational, or healthcare practice-related factors that may influence the survival differences of T2 GBC in different regions.

来自不同国家的已发表的有关T2胆囊癌（GBC）生存率的数据显示，5年生存率范围从30％至70％不等。最近，研究表明，各国对胆囊采样的方法存在很大差异，此外，来自不同大陆的病理学家在确定该器官的侵袭阶段时采用了高度可变的标准。这些发现提出了这样一个问题，即病理学评估中的这些差异是否可以解释文献中报道的T2 GBC生存率差异很大。在这项研究中，来自三个国家的316个GBC的存活率（智利n = 137，韩国n = 105，美国n= 74），所有样本均进行了充分采样（至少检查了五个肿瘤切片），并经组织病理学验证为pT2（经过来自三大洲的专家病理学家的共识检查）。智利患者的5年全因死亡率（HR：1.89，95％CI：1.27–2.83，p = 0.002）和因疾病而异的死亡率（HR：2.41，95％CI：1.51–3.84）使预后明显恶化，p <0.001），与韩国同行相比，即使在控制年龄和性别的情况下也是如此。比较美国和韩国，全因死亡率（HR：1.75，95％CI：1.12–2.75，p = 0.015）和疾病特异性死亡率（HR：1.94，95％CI：1.14–3.31，p= 0.015）。韩国，美国和智利的3年特定疾病生存率分别为75％，65％和55％，5年特定疾病生存率分别为60％，50％和50％ ，整体5年生存率分别为55％，45％和35％。总之，在正确分类的病例中，真正的T2 GBC的存活率既不像文献中先前记录的那样好，也没有那么差，即使在采用一致的组织病理学标准的充分采样的病例中，也显示出显着的地理差异。未来的研究应侧重于其他可能的原因，包括可能影响T2 GBC在不同地区生存差异的生物学，病因，管理相关，人群或医疗保健相关因素。