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 outpa-tient 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 lymphadenec-tomy,extended lymphadenectomy does not improve the overall survival of patients with stage T2b gallbladder cancer.
NETL
NSTL
万方数据
