title: Surgical treatment of advanced gallbladder cancer.
abstract: OBJECTIVE
  Radical lymph node dissection in surgery for advanced gallbladder cancer is controversial. The purpose of this study is to evaluate the different extent of lymph node dissection for N2 stage gallbladder cancer patients.
  
  
  METHODS
  A retrospective analysis was made of 60 patients with N2 stage who underwent standard regional lymphadenectomy (SRLN) and extended regional lymphadenectomy (ERLN). Between September 2000 and June 2011, 60 advanced gallbladder cancer patients with N2 stage of lymph node metastasis were included in this study. The curative effects with different extent of lymphadenctomy for lymph node N2 stage of gallbladder cancer patients were compared.
  
  
  RESULTS
  The median survival time was 34.83 months in the SRLN group and 30.28 months in the ERLN group. There was no significant difference of survival rate between SRLN and ERLN group (P=0.51). Postoperative major morbidity and mortality rates were 64.3% and 7.14% in the SRLN group, 81.3% and 9.34% in the ERLN group, respectively. Moreover, the number of positive lymph nodes and chemotherapy were found to correlate with survival on univariate analyses (P<0.05).
  
  
  CONCLUSIONS
  For advanced gallbladder patients with N2 stage lymph node metastasis, ERLN cannot provide a significant survival benefit over SRLN and the rate of morbidity and mortality in ERLN is exceptionally high. ERLN therefore should not be considered in the advanced gallbladder cancers with N2 stage.
authors.affiliation: Department of Hepatobiliary Surgery, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
authors.forename: Guang Cai
authors.initials: GC
authors.lastname: Niu
authors.forename: Chang Ming
authors.initials: CM
authors.lastname: Shen
authors.forename: Wei
authors.initials: W
authors.lastname: Cui
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000231:Adenocarcinoma, Papillary / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000473:pathology / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D002763:Cholecystectomy / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005706:Gallbladder Neoplasms / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome