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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 7/2010

01-07-2010 | Hepatobiliary Tumors

Number of Positive Lymph Nodes Independently Determines the Prognosis After Resection in Patients with Gallbladder Carcinoma

Authors: Jun Sakata, MD, Yoshio Shirai, MD, Toshifumi Wakai, MD, Yoichi Ajioka, MD, PhD, Katsuyoshi Hatakeyama, MD, FACS

Published in: Annals of Surgical Oncology | Issue 7/2010

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Abstract

Background

This study was designed to compare the prognostic power of the location of positive lymph nodes with that of the number of positive lymph nodes in gallbladder carcinoma.

Methods

A retrospective analysis was conducted of 116 consecutive patients who underwent an R0 radical resection for gallbladder carcinoma. A total of 2,406 lymph nodes taken from the patients were examined histologically. The location of positive regional nodes was classified according to the Japanese staging system. The number of positive regional nodes was recorded for each patient.

Results

Nodal disease was found in 49 patients, of whom 19 survived for more than 5 years after resection. Univariate analysis revealed that both the location (P < 0.0001) and the number (P < 0.0001) of positive nodes were significant prognostic factors. Multivariate analysis revealed that the number of positive nodes was an independent prognostic factor (P < 0.001), whereas the location of positive nodes failed to remain as an independent variable. The cumulative 5-year survival rates were 81% for patients without regional nodal disease, 62% for patients with a single positive node, 43% for patients with 2–3 positive nodes, and 15% for patients with ≥4 positive nodes (P < 0.0001).

Conclusions

The number, not the location, of positive lymph nodes independently determines the prognosis after resection in gallbladder carcinoma. No nodal disease or a single positive node indicates a favorable outcome after resection, whereas radical lymph node dissection is effective for selected patients with multiple positive nodes, provided that an R0 resection is feasible.
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Metadata
Title
Number of Positive Lymph Nodes Independently Determines the Prognosis After Resection in Patients with Gallbladder Carcinoma
Authors
Jun Sakata, MD
Yoshio Shirai, MD
Toshifumi Wakai, MD
Yoichi Ajioka, MD, PhD
Katsuyoshi Hatakeyama, MD, FACS
Publication date
01-07-2010
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 7/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-009-0899-1

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