Appropriate extent of lymph node dissection in patients with muscle-invasive gallbladder cancer.

IF 2.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2025-08-21 DOI:10.1016/j.hpb.2025.08.005

Won-Gun Yun, Youngmin Han, Yoon S Chae, Young J Cho, Hye-Sol Jung, Joon S Park, Jin-Young Jang, Wooil Kwon

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引用次数: 0

Abstract

Background: The appropriate extent of lymph node dissection has not yet been standardized in muscle-invasive gallbladder cancer.

Methods: Patients who underwent surgery, and were histologically diagnosed with muscle-invasive gallbladder cancer were included. Patients were classified as having Na, Nb, or Nc disease if their nodal metastases were limited to the porta hepatis and extended to the posterosuperior pancreatic head lymph nodes (PSPLNs), nodes along the celiac axis, or superior mesenteric vessels.

Results: Among 137 patients with node metastases, 96 (70.1 %), 30 (21.9 %), and 11 (8.0 %) were assigned to the Na, Nb, and Nc groups, respectively. The Na (52.9 %) and Nb (34.1 %) groups showed significantly higher 5-year overall survival rates than the palliative surgery group (3.9 %), whereas the 5-year overall survival rates were comparable between the Nc and palliative surgery groups (18.2 % vs. 3.9 %, P = 0.055). Among 230 patients without node metastases, those who underwent lymph node dissection including the PSPLNs (88.7 %) showed a significantly higher 5-year overall survival rate than those underwent node dissection only up to the nodes at the porta hepatis (78.7 %, P = 0.045).

Conclusion: PSPLNs and nodes along the porta hepatis should be considered as regional nodes for gallbladder cancer and should be resected.

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肌肉浸润性胆囊癌患者淋巴结清扫的适当程度。

背景：肌肉浸润性胆囊癌淋巴结清扫的适当程度尚未标准化。方法：接受手术并经组织学诊断为肌肉浸润性胆囊癌的患者。如果患者的淋巴结转移局限于肝门，并扩展到胰头后上淋巴结（pspln）、沿腹腔轴的淋巴结或肠系膜上血管，则将其分类为Na、Nb或Nc疾病。结果：137例淋巴结转移患者中，Na组96例（70.1%），Nb组30例（21.9%），Nc组11例（8.0%）。Na组（52.9%）和Nb组（34.1%）的5年总生存率显著高于姑息手术组（3.9%），而Nc组和姑息手术组的5年总生存率相当（18.2% vs. 3.9%, P = 0.055）。230例无淋巴结转移患者中，包括pspln的淋巴结清扫组（88.7%）的5年总生存率明显高于仅肝门淋巴结清扫组（78.7%,P = 0.045）。结论：pspln及沿肝门的淋巴结应考虑为胆囊癌的局部淋巴结，应予以切除。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).