The Influence Of The Extent Of Lymphadenectomy On The Prognosis Of Primary Gallbladder Carcinoma

ObjectiveIn this study, we maked survival analysis through analyzing the clinical data of gallbladder carcinoma Patients. Reference for evaluating the prognosis of gallbladder carcinoma and determining the effect of the number, and the range of lymphadenectomy on the prognosis of patients with gallbladder carcinoma. MethodsThe clinical data of 70 patients with gallbladder cancer who had complete follow-up data from 2013.1 to 2009.1 in our hospital were retrospectively analyzed.13 possible prognostic factorsl: lymph node metastasis, operative methods, pathological factors of the prognosis of patients with gallbladder carcinoma were selected, and the single factor analysis and COX risk model analysis were carried out by using SPSS 19. exploring the effect of the number, order, and range of lymphadenectomy on the prognosis of patients with gallbladder cancer combined with literature data. Results1. The mean survival time was 23.3 months(95%CI, 17.4 to 29.2 months). The median survival time was 13 months, and the actuarial 0.5-, 1-,2-, 3-, and 5-year survival rates in the 70 resected cases were 68.4%?52.4%?37.8%?27.5%?6.9%respectively.2. The univariate analysis showed that Sex, preoperative liver function, preoperative jaundice, preoperative serum level of CA19-9, Lymph node metastasis, operation method, liver invasion, tumor differentiation, TNM stage significantly correlated with the prognosis of the patients(P<0.05). the multivariate analysis(Cox regression) showed operation mode, lymph node metastasis, TNM staging were independent prognostic factor for the patients with gallbladder cancer. Palliative surgery, lymph node metastasis and death risk were increased by 2.093, 1.905 and 10.809 times respectively.3. The presence of lymph node metastasis is an important factor affecting the prognosis of patients with gallbladder cancer after radical operation. Gallbladder cancer lymph node dissection principle is: at least 6 lymph nodes need to be removed. Lymph node biopsy was alaways performed at the upper part(Group 13a) and abdominal aorta(16 groups):(1) the dividing point of the first lymph node and the second lymph node of gallbladder cancer is the 13 a group, The positive results showed that there were second lymph nodes metastasis;(2) the 16 group of lymph nodes is the end point of gallbladder cancer lymph node metastasis, and positive indicated a distant metastasis, it means that the basis of radical surgery should be abandoned. ConclusionRadical surgery, including lymphadenectomy can improve patient outcomes. Gallbladder cancer lymphadenectomy should be based on the principle of lymph node station, Above the head of the pancreas, the abdominal aortic lymph nodes are important points. Palliative surgery, lymph node metastasis, advanced patients have poor prognosis...