caa a22 4500 475791037 CHVBK 20180406123710.0 cr unu---uuuuu 170329e20001201xx s 000 0 eng 10.1007/s004230000163 doi (NATIONALLICENCE)springer-10.1007/s004230000163 Appraisal of surgical resection of gallbladder cancer with special reference to lymph node dissection [Elektronische Daten] [Hiroshi Shimada, Itaru Endo, Yoshiro Fujii, Noriyuki Kamiya, Hideki Masunari, Osamu Kunihiro, Kuniya Tanaka, Kouichiro Misuta, Shinji Togo] Abstract.: Background: Radical lymph node dissection in surgery for advanced gallbladder cancer is controversial. The purpose of this study is to evaluate the role of lymph node dissection based on the clinico-pathologic results. Patients: Seventy-three patients who underwent radical surgery including systematic dissection of the N1+N2 region lymph node plus some of the para-aortic nodes were reviewed. Results: pT1 patients had no lymph node metastasis, but pT2 and pT3/pT4 patients had lymph node metastasis at a rate of 50.0% (13/26) and 83.3% (25/30), respectively. As infiltration of the hepatoduodenal ligament (Binf) became severe, the rate and extent of lymph node metastasis increased. There were four 5-year survivors with lymph node involvement. The 5-year survival rates are 77.0% in pN0 cases and 27.3% in pN1 cases (P<0.01). There was no difference in survival between pN1 and pN2 patients. However, significant differences in survival were observed between pN0/1 and pN2/3 patients when these patients were limited to Binf0/1. Examination of the recurrence pattern showed that most patients with pN0/1/2 had no regional lymph node recurrence, but there was para-aortic lymph node recurrence in patients with pN3 outside the dissected region. Significant prognostic factors influencing survival after surgery by multivariate analysis were pN2/3, pT, and residual tumor. Conclusion: Systematic lymph node dissection of N1, N2, and part of the para-aortic region improves survival in advanced gallbladder cancer patients, especially in those without either para-aortic lymph node metastases or Binf2/3. Springer-Verlag, 2000 Systematic lymph node dissection Radical surgery Recurrence pattern Clinical outcome Indication nationallicence Shimada Hiroshi Department of Surgery II, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan aut Endo Itaru Department of Surgery II, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan aut Fujii Yoshiro Department of Surgery II, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan aut Kamiya Noriyuki Department of Surgery II, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan aut Masunari Hideki Department of Surgery II, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan aut Kunihiro Osamu Department of Surgery II, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan aut Tanaka Kuniya Department of Surgery II, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan aut Misuta Kouichiro Department of Surgery II, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan aut Togo Shinji Department of Surgery II, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan aut https://doi.org/10.1007/s004230000163 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004230000163 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shimada Hiroshi Department of Surgery II, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan aut NATIONALLICENCE 700 1- Endo Itaru Department of Surgery II, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan aut NATIONALLICENCE 700 1- Fujii Yoshiro Department of Surgery II, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan aut NATIONALLICENCE 700 1- Kamiya Noriyuki Department of Surgery II, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan aut NATIONALLICENCE 700 1- Masunari Hideki Department of Surgery II, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan aut NATIONALLICENCE 700 1- Kunihiro Osamu Department of Surgery II, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan aut NATIONALLICENCE 700 1- Tanaka Kuniya Department of Surgery II, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan aut NATIONALLICENCE 700 1- Misuta Kouichiro Department of Surgery II, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan aut NATIONALLICENCE 700 1- Togo Shinji Department of Surgery II, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer