Brief Reports
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 7, 2005; 11(5): 748-751
Published online Feb 7, 2005. doi: 10.3748/wjg.v11.i5.748
Metastasis of primary gallbladder carcinoma in lymph node and liver
Han-Ting Lin, Gui-Jie Liu, Dan Wu, Jian-Ying Lou
Han-Ting Lin, Gui-Jie Liu, Dan Wu, Jian-Ying Lou, Department of General Surgery, the Second Affiliated Hospital of Medical College, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
Author contributions: All authors contributed equally to the work.
Correspondence to: Professor Han-Ting Lin, Department of General Surgery, the Second Affiliated Hospital of Medical College, Zhejiang University, Hangzhou 310009, Zhejiang Province, China. zjulgj@163.com
Telephone: +86-571-87783581
Received: April 9, 2004
Revised: April 12, 2004
Accepted: May 13, 2004
Published online: February 7, 2005
Abstract

AIM: To evaluate the patterns with metastasis of gallbladder carcinoma in lymph nodes and liver.

METHODS: A total of 45 patients who had radical surgery were selected. The patterns with metastasis of primary gallbladder carcinoma in lymph nodes and liver were examined histopathologically and classified as TNM staging of the American Joint Committee on Cancer.

RESULTS: Of the 45 patients, 29 (64.4%) had a lymph node positive disease and 20 (44.4%) had a direct invasion of the liver. The frequency of involvement of lymph nodes was strongly influenced by the depth of the primary tumor (P = 0.0001). The postoperative survival rate of patients with negative lymph node metastasis was significantly higher than that of patients with positive lymph node metastasis (P = 0.004), but the postoperative survival rate of patients with N1 lymph node metastasis was not significantly different from that of patients with N2 lymph node metastasis (P = 0.3874). The postoperative survival rate of patients without hepatic invasion was significantly better than that of patients with hepatic invasion (P = 0.0177).

CONCLUSION: Complete resection of the regional lymph nodes is important in advanced primary gallbladder carcinoma (PGC). The initial sites of liver spread are located mostly in segments IV and V. It is necessary to achieve negative surgical margins 2 cm from the tumor. In patients with hepatic hilum invasion, extended right hepatectomy with or without bile duct resection or portal vein resection is necessary for curative resection.

Keywords: Gallbladder carcinoma; Liver cancer; Lymph node metastasis