What is the recommended initial treatment for T1a gallbladder cancer?

The recommended initial treatment for T1a gallbladder cancer is cholecystectomy. This approach is based on the understanding that T1a represents a very early stage of gallbladder cancer, where the tumor is confined to the gallbladder with no invasion into the muscularis propria or beyond.

Cholecystectomy, which involves the surgical removal of the gallbladder, can be curative in this scenario. It effectively eliminates the tumor and addresses any associated pathological concerns such as dysplasia or carcinoma in situ. For T1a tumors, this procedure is typically performed laparoscopically unless there are specific contraindications.

Other treatment modalities such as chemotherapy or radiation therapy are generally not indicated as primary treatments for localized early-stage gallbladder cancer, particularly at this very initial stage. Hepatectomy may be considered in cases of more advanced disease or when there is invasion into adjacent liver tissue, but for T1a, the appropriate strategy remains focused on surgical intervention through cholecystectomy.