Abstract
Motomi YOSHIDA, Tsukasa AZUMA, Mituji NAKAMURA, Fujio HANYU This study was designed to evaluate the significance of paraaortic lymph node dissection forgallbladder cancer, retrospectively. Paraaortic lymph node dissection was performed in 44 patients with gallbladder cancer who underwent surgical resection. In 11 patients out of 44 patients (25%), positive paraaortic lymph nodes metastasizes were recognized microscopically. The incidence of positive paraaortic lymph node metastasis was 26.8% in advanced cancer which involved subserosa or mere seriously invaded. Positive paraaortic lymph node metastasis was recognized in 30.0%when cancer occpied at the neck and in 28.6% when cancer widely spreaded in the body and fundus of gallbladder, respectively. In early cancer (cancer invaded until proper muscle), no paraaortic lymph node metastasis was recognized. On surgical results,5 year survival rates of the group which paraaortic lymph nodes were dissected was 47.6%, and significantly better than that of non -dissecting paraaortic lymph nodes group (18.2%). In spite of positive paraaortic lymph node metastasis,1 patient who had had no other non curative factor survived for mere than 3 years, the other patients with non curative factor except for paraaortic lymph node or 1 patient with wide spreaded positive paraaortic lymph node matastasis were dead within 1 month following surgery. No major postoperative complication due to dissection of paraaortic lymph node has not been encountered. The quality of life of 1 year survivals (n=21) were almost fair (Grade 0-1: 95%). Therefore we concluded that paraaortic lymph node dissection was one of the major factors to improve the survival for advanced gallbladder cancer.
