Regional and para-aortic lymphadenectomy in radical surgery for advanced gallbladder carcinoma

Citation
S. Kondo et al., Regional and para-aortic lymphadenectomy in radical surgery for advanced gallbladder carcinoma, BR J SURG, 87(4), 2000, pp. 418-422
Citations number
22
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Surgery,"Medical Research Diagnosis & Treatment
Journal title
BRITISH JOURNAL OF SURGERY
ISSN journal
0007-1323 → ACNP
Volume
87
Issue
4
Year of publication
2000
Pages
418 - 422
Database
ISI
SICI code
0007-1323(200004)87:4<418:RAPLIR>2.0.ZU;2-H
Abstract
Background: There have been no reports on the routine use of regional and p ara-aortic lymphadenectomy for gallbladder cancer. The aim of this study wa s to elucidate nodal status, its prognostic influence and the efficacy of l ymphadenectomy. Methods: A retrospective analysis was made of 60 patients who underwent rad ical resection and routine regional and para-aortic lymphadenectomy. Results: Of the 60 patients, 73 per cent had node-positive disease and 38 p er cent had positive para-aortic nodes. Postoperative survival was extremel y poor in patients with minimal distant metastasis, and similarly in patien ts with para-aortic disease. The survival of patients with metastasis limit ed to the regional nodes was significantly better than that of those with d istant metastasis (P = 0.029) or para-aortic disease (P = 0.017) and was no t significantly different from that of patients with no metastasis (P = 0.8 2). Conclusion: Regional and para-aortic lymphadenectomy provides no survival b enefit for patients with para-aortic disease, which has an influence on poo r prognosis equivalent to that of distant metastasis. It has the potential to bring survival benefit only in selected patients with metastasis limited to the regional nodes. A sampling biopsy of the para-aortic nodes before s tarting radical surgery is recommended because they are involved more frequ ently than expected.