Impact of the number of examined lymph nodes on outcomes in patients with lymph node-negative gallbladder carcinoma

(整期优先)网络出版时间:2018-12-22
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AIMTodeterminewhetherthenumberofexaminedlymphnodes(LNs)iscorrelatedwiththeoverallsurvivalofgallbladdercarcinoma(GBC)patients.METHODSPatientswerecollectedfromtheSurveillanceEpidemiologyandEndResultsdatabase(2004-2013)andcategorizedbythenumberofLNsintosixgroups:1LN,2LNs,3LNs,4LNs,5LNs,and≥6LNs.SurvivalcurvesforoverallsurvivalwereplottedwithaKaplan-Meieranalysis.Thelog-ranktestwasusedforunivariatecomparisons.RESULTSInacohortof893patients,themediannumberofexaminedLNswastwofortheentirecohort.Thesurvivalforthe1LNgroupwassignificantlypoorerthanthoseofthestageⅠandⅡdiseasegroupsandfortheentirecohort.BydichotomizingthenumberofLNsfrom1to6,wefoundthattheminimumnumberofLNsthatshouldbeexaminedwasfourforstageⅠ,fourorfiveforstageⅡ,andsixforstageⅢAdisease.Therefore,fortheentirecohort,thenumberofexaminedLNsshouldbeatleastsix,whichisexactlyconsistentwiththeAmericanJointCommitteeonCancercriteria.CONCLUSIONTheexaminationofhighernumbersofLNsisassociatedwithimprovedsurvivalafterresectionsurgeryforN0GBC.TheguidelinesforGBCsurgery,whichrecommendthatsixLNsbeexaminedatleast,arestatisticallyvalidandshouldbeappliedinclinicalpracticewidely.