Prognostic significance of regional lymphadenectomy in T1b gallbladder cancer: Results from 24 hospitals in China
| Autor: | Wan Yee Lau, Bo Yang, Xiaoqing Jiang, Zhe-Wei Fei, Chong Jin, Ya-Wei Hua, Chang-Jun Liu, Xi Zhang, Yongsheng Li, Hong Cao, Hong-Yu Cai, Bei Sun, Kun-Hua Wang, Yijun Shu, Chao-Liu Dai, Jian-Feng Gu, Ying-Bin Liu, Yunfu Cui, Jun Liu, Yang Li, Linhui Zheng, Jing-Yu Cao, Xue-Yi Dang, Ziyu Shao, Yi Wang, Bing Li, Zai-Yang Zhang, Tai Ren, Xiangsong Wu, Hui-Han Jin, Maolan Li, Xu'an Wang, Runfa Bao, Wenguang Wu, Chang Liu, Chun-Fu Zhu, Ye-Ben Qian |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Staging business.industry medicine.medical_treatment General surgery Observational Study Lymphadenectomy medicine.disease Gallbladder cancer Prognosis Surgery 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis medicine Hepatectomy 030211 gastroenterology & hepatology business |
| Zdroj: | World Journal of Gastrointestinal Surgery |
| ISSN: | 1948-9366 |
| Popis: | BACKGROUND Whether regional lymphadenectomy (RL) should be routinely performed in patients with T1b gallbladder cancer (GBC) remains a subject of debate. AIM To investigate whether RL can improve the prognosis of patients with T1b GBC. METHODS We studied a multicenter cohort of patients with T1b GBC who underwent surgery between 2008 and 2016 at 24 hospitals in 13 provinces in China. The log-rank test and Cox proportional hazards model were used to compare the overall survival (OS) of patients who underwent cholecystectomy (Ch) + RL and those who underwent Ch only. To investigate whether combined hepatectomy (Hep) improved OS in T1b patients, we studied patients who underwent Ch + RL to compare the OS of patients who underwent combined Hep and patients who did not. RESULTS Of the 121 patients (aged 61.9 ± 10.1 years), 77 (63.6%) underwent Ch + RL, and 44 (36.4%) underwent Ch only. Seven (9.1%) patients in the Ch + RL group had lymph node metastasis. The 5-year OS rate was significantly higher in the Ch + RL group than in the Ch group (76.3% vs 56.8%, P = 0.036). Multivariate analysis showed that Ch + RL was significantly associated with improved OS (hazard ratio: 0.51; 95% confidence interval: 0.26-0.99). Among the 77 patients who underwent Ch + RL, no survival improvement was found in patients who underwent combined Hep (5-year OS rate: 79.5% for combined Hep and 76.1% for no Hep; P = 0.50). CONCLUSION T1b GBC patients who underwent Ch + RL had a better prognosis than those who underwent Ch. Hep + Ch showed no improvement in prognosis in T1b GBC patients. Although recommended by both the National Comprehensive Cancer Network and Chinese Medical Association guidelines, RL was only performed in 63.6% of T1b GBC patients. Routine Ch + RL should be advised in T1b GBC. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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