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Effect of lymphadenectomy on the prognosis for N0 gallbladder carcinoma patients: A study based on SEER database

BACKGROUND: It remains unclear whether lymph node dissection is necessary for patients with N0 gallbladder carcinoma (GBC). The objective of this study was to evaluate the effect of lymphadenectomy on the prognosis for N0 GBC patients. The secondary objective was to establish a prognostic model of s...

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Autores principales: Wu, Bin, Shen, Yiyu, Chen, Xujian, Wang, Xiaoguang, Zhong, Zhengxiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8525154/
https://www.ncbi.nlm.nih.gov/pubmed/34519168
http://dx.doi.org/10.1002/cam4.4250
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author Wu, Bin
Shen, Yiyu
Chen, Xujian
Wang, Xiaoguang
Zhong, Zhengxiang
author_facet Wu, Bin
Shen, Yiyu
Chen, Xujian
Wang, Xiaoguang
Zhong, Zhengxiang
author_sort Wu, Bin
collection PubMed
description BACKGROUND: It remains unclear whether lymph node dissection is necessary for patients with N0 gallbladder carcinoma (GBC). The objective of this study was to evaluate the effect of lymphadenectomy on the prognosis for N0 GBC patients. The secondary objective was to establish a prognostic model of survival for N0 GBC patients being founded on the large samples. METHODS: Patient data were obtained from the database named SEER (Surveillance, Epidemiology, and End Results database) between 2010 and 2014. Analyses of Kaplan–Meier survival and multivariate Cox regression were performed in subgroups based on regional lymph nodes removal (LNR) to calculate the excess risk of cause‐specific death. A prognosis nomogram was constructed build on the results of a multivariate analysis to predict the specific survival time (CSS) rates of N0 GBC patients. RESULT: A total of 1406 N0 GBC patients were included in this research. The majority of N0 GBC patients undergoing cancer‐directed surgery did not undergo LNR (64.5%). The results showed that LNR can improve the survival of N0 GBC patients, including those at the T1a and T1b stages, and a wider range of lymph node dissection (LNR2) compared to LNR1 was more conducive to the prognosis. Furthermore, multivariate regression analysis showed that LNR was an independent favorable prognostic factor of N0 GBC. Finally, a nomogram was constructed to accurately predict the prognosis of N0 gallbladder cancer patients. CONCLUSION: This study demonstrated a significant survival benefit for extended lymph nodes removed in N0 GBC patients. These results recommend that an extended lymph node dissection strategy is needed for N0 GBC patients.
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spelling pubmed-85251542021-10-26 Effect of lymphadenectomy on the prognosis for N0 gallbladder carcinoma patients: A study based on SEER database Wu, Bin Shen, Yiyu Chen, Xujian Wang, Xiaoguang Zhong, Zhengxiang Cancer Med Clinical Cancer Researcher BACKGROUND: It remains unclear whether lymph node dissection is necessary for patients with N0 gallbladder carcinoma (GBC). The objective of this study was to evaluate the effect of lymphadenectomy on the prognosis for N0 GBC patients. The secondary objective was to establish a prognostic model of survival for N0 GBC patients being founded on the large samples. METHODS: Patient data were obtained from the database named SEER (Surveillance, Epidemiology, and End Results database) between 2010 and 2014. Analyses of Kaplan–Meier survival and multivariate Cox regression were performed in subgroups based on regional lymph nodes removal (LNR) to calculate the excess risk of cause‐specific death. A prognosis nomogram was constructed build on the results of a multivariate analysis to predict the specific survival time (CSS) rates of N0 GBC patients. RESULT: A total of 1406 N0 GBC patients were included in this research. The majority of N0 GBC patients undergoing cancer‐directed surgery did not undergo LNR (64.5%). The results showed that LNR can improve the survival of N0 GBC patients, including those at the T1a and T1b stages, and a wider range of lymph node dissection (LNR2) compared to LNR1 was more conducive to the prognosis. Furthermore, multivariate regression analysis showed that LNR was an independent favorable prognostic factor of N0 GBC. Finally, a nomogram was constructed to accurately predict the prognosis of N0 gallbladder cancer patients. CONCLUSION: This study demonstrated a significant survival benefit for extended lymph nodes removed in N0 GBC patients. These results recommend that an extended lymph node dissection strategy is needed for N0 GBC patients. John Wiley and Sons Inc. 2021-09-14 /pmc/articles/PMC8525154/ /pubmed/34519168 http://dx.doi.org/10.1002/cam4.4250 Text en © 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Cancer Researcher
Wu, Bin
Shen, Yiyu
Chen, Xujian
Wang, Xiaoguang
Zhong, Zhengxiang
Effect of lymphadenectomy on the prognosis for N0 gallbladder carcinoma patients: A study based on SEER database
title Effect of lymphadenectomy on the prognosis for N0 gallbladder carcinoma patients: A study based on SEER database
title_full Effect of lymphadenectomy on the prognosis for N0 gallbladder carcinoma patients: A study based on SEER database
title_fullStr Effect of lymphadenectomy on the prognosis for N0 gallbladder carcinoma patients: A study based on SEER database
title_full_unstemmed Effect of lymphadenectomy on the prognosis for N0 gallbladder carcinoma patients: A study based on SEER database
title_short Effect of lymphadenectomy on the prognosis for N0 gallbladder carcinoma patients: A study based on SEER database
title_sort effect of lymphadenectomy on the prognosis for n0 gallbladder carcinoma patients: a study based on seer database
topic Clinical Cancer Researcher
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8525154/
https://www.ncbi.nlm.nih.gov/pubmed/34519168
http://dx.doi.org/10.1002/cam4.4250
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