Swati H Shah1, Nikhil Gupta1, Gurudutt Gupta2, Anurag Mehta2, Shivendra Singh3. 1. Department of GI Oncosurgery, Rajiv Gandhi Cancer Institute and Research Center, Sector 5, New Delhi, 110 085, India. 2. Department of Pathology, Rajiv Gandhi Cancer Institute and Research Center, Sector 5, New Delhi, 110 085, India. 3. Department of GI Oncosurgery, Rajiv Gandhi Cancer Institute and Research Center, Sector 5, New Delhi, 110 085, India. shiven_24@yahoo.co.in.
Abstract
BACKGROUND: Prognosis of gallbladder cancer (GBC) is grim even after curative surgery. Lymph node metastasis is the most important prognostic factor, but distant relapses occurring in their absence point towards additional factor. Lymph node micrometastasis could be one. The present study aimed to evaluate the incidence and clinical significance of lymph node micrometastasis. METHODS: This is a prospective study of patients undergoing curative surgery for GBC from 1 March 2013 to 30 April 2015, at our institute. All lymph nodes were examined with hematoxylin and eosin and immunohistochemistry against CK7. The incidence of lymph node and its relation to other clinicopathological parameters, recurrence, and survival was evaluated. RESULTS: Out of 589 lymph nodes retrieved from 40 patients, metastasis was seen in 13 (2.20%) nodes from 8 (20%) patients and micrometastasis in 4 (0.68%) nodes from 3 (7.5%) patients. Micrometastases were absent in pT1 tumors (0/10 in pT1 vs. 3/30 in pT2-4) and more common in patients with nodal metastasis (13% vs. 6%). Though the presence of micrometastasis would have upstaged the disease, it did not statistically relate to clinicopathological parameters, recurrence, and survival. CONCLUSIONS: Incidence of lymph node micrometastasis in GBC was low and did not correlate with other clinicopathological parameters, recurrence, and survival.
BACKGROUND: Prognosis of gallbladder cancer (GBC) is grim even after curative surgery. Lymph node metastasis is the most important prognostic factor, but distant relapses occurring in their absence point towards additional factor. Lymph node micrometastasis could be one. The present study aimed to evaluate the incidence and clinical significance of lymph node micrometastasis. METHODS: This is a prospective study of patients undergoing curative surgery for GBC from 1 March 2013 to 30 April 2015, at our institute. All lymph nodes were examined with hematoxylin and eosin and immunohistochemistry against CK7. The incidence of lymph node and its relation to other clinicopathological parameters, recurrence, and survival was evaluated. RESULTS: Out of 589 lymph nodes retrieved from 40 patients, metastasis was seen in 13 (2.20%) nodes from 8 (20%) patients and micrometastasis in 4 (0.68%) nodes from 3 (7.5%) patients. Micrometastases were absent in pT1tumors (0/10 in pT1 vs. 3/30 in pT2-4) and more common in patients with nodal metastasis (13% vs. 6%). Though the presence of micrometastasis would have upstaged the disease, it did not statistically relate to clinicopathological parameters, recurrence, and survival. CONCLUSIONS: Incidence of lymph node micrometastasis in GBC was low and did not correlate with other clinicopathological parameters, recurrence, and survival.
Authors: William R Jarnagin; Leyo Ruo; Sarah A Little; David Klimstra; Michael D'Angelica; Ronald P DeMatteo; Raquel Wagman; Leslie H Blumgart; Yuman Fong Journal: Cancer Date: 2003-10-15 Impact factor: 6.860