Analysis of the impact of lymph node dissection on the prognosis of stage T2b gallbladder cancer
10.3760/cma.j.cn113884-20240415-00107
- VernacularTitle:胆囊癌根治术中淋巴结清扫范围对T2b期胆囊癌患者预后的影响
- Author:
Lin LI
1
;
Xuechuan LI
;
Ke LIU
;
Lu ZOU
;
Maolan LI
;
Yingbin LIU
Author Information
1. 上海交通大学医学院附属仁济医院胆胰外科 上海市肿瘤系统调控与临床转化重点实验室 肿瘤系统医学全国重点实验室，上海 200127
- Keywords:
Gallbladder neoplasms;
Lymphadenectomy;
T2b staging
- From:
Chinese Journal of Hepatobiliary Surgery
2024;30(6):407-411
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the impact of lymph node dissection in radical surgery on the prognosis for patients with stage T2b gallbladder cancer.Methods:Forty-seven patients undergoing radical surgery for T2b gallbladder cancer at Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from June 2009 to May 2020 were retrospectively analyzed, including 17 males and 30 females, aged 68(58, 72) years old. According to the extent of lymph node dissection, patients were divided into the regional lymph node dissection group ( n=28) and extended lymph node dissection group ( n=19). Clinical data including the level of carbohydrate antigen 19-9 (CA19-9), fashions of liver parenchymal resection, and postoperative complications were recorded. Survival follow-up was conducted through telephone or outpatient review. Survival analysis was conducted using Kaplan-Meier method and compared using the log-rank test. Cox regression analysis was used to identify the risk factors of overall survival. Results:Compared to regional lymph node dissection, the extended lymph node dissection group had a longer operative time [195(167, 220) min vs. 165(152, 175) min] and a greater number of lymph nodes dissected [12(9, 14) vs. 8(7, 9)] (both P<0.05). The postoperative complication rates of the two groups were 14.3%(4/28) and 21.1%(4/19), respectively ( P=0.697). The cumulative postoperative 1-, 3-, and 5-year survival rates were 96.4%, 59.4%, and 52.8% in regional lymph node dissection group, and 84.2%, 62.7%, and 43.0% in extended lymph node dissection group, respectively, with no significant difference ( P=0.643). Multivariate Cox regression analysis indicated that CA19-9>40 IU/ml ( HR=2.98, 95% CI: 1.24-7.18, P=0.014), wedge resection of the liver ( HR=4.01, 95% CI: 1.36-11.87, P=0.011), and positive lymph node ( HR=2.99, 95% CI: 1.22-7.34, P=0.016) were independent risk factors for poor prognosis in patients with stage T2b gallbladder cancer. Conclusion:Compared with regional lymphadenectomy, extended lymphadenectomy does not improve the overall survival of patients with stage T2b gallbladder cancer.
