Assessment of lymph node status in gallbladder cancer: location, number, or ratio of positive nodes

Table 2 Factors influencing long-term survival after resection in 135 patients with gallbladder cancer

Variable	Number of patients	Survival rate (%)		Univariate analysis	Multivariate analysis
		5-year	10-year	P value	Relative risk (95% CI)	P value
Age (years)				0.123
≤70	86	66	63
>70	49	52	49
Sex				0.652
Male	41	66	61
Female	94	59	57
Gallstone				0.028		0.003
Absent	73	52	50		2.801 (1.435-5.470)
Present	62	72	68		1.000
Type of radical resection				<0.001
Extended cholecystectomy	93	77	76
Major hepatectomy	19	9	9
Pancreaticoduodenectomy	15	45	28
Major hepatectomy with pancreaticoduodenectomy	8	25	25
Timing of radical resection				0.007
Initial radical resection	111	56	52
Radical second resection	24	86	86
Adjuvant chemotherapy				0.093
Absent	85	57	52
Present	50	68	68
Size of the primary tumor (mm)				0.869
≤60	68	61	59
>60	67	61	57
pT classification*				<0.001		0.005
pT1 plus pT2	80	87	85		1.000
pT3 plus pT4	55	21	15		3.145 (1.412-6.948)
Total lymph node count (TLNC)				0.102
≤16	76	66	66
>16	59	55	48
Location of positive lymph nodes*				<0.001
pN0	76	80	80
pN1	24	57	46
pN2	35	23	20
Number of positive lymph nodes				<0.001		0.004
0	76	80	80		1.000
1-3	39	51	41		1.640 (0.784-3.431)
≥4	20	10	10		4.997 (1.905-13.003)
Lymph node ratio (LNR; %)				<0.001
0	76	80	80
0-10	22	60	49
>10	37	24	20
pM classification*				<0.001		0.014
pM0	109	72	69		1.000
pM1	26†	13	7		2.260 (1.178-4.337)
Histological type*				<0.001
Adenocarcinoma	114	66	64
Others	21	32	26
Histological grade*				0.001		<0.001
G1 plus G2	96	68	67		1.000
G3 plus G4	39	42	34		3.472 (1.766-6.828)
Lymphatic vessel invasion (L)*				<0.001
L0	57	85	83
L1	78	44	41
Venous invasion (V)*				<0.001		0.007
V0	74	78	76		1.000
V1	61	41	37		2.445 (1.279-4.673)
Perineural invasion				<0.001
Absent	88	77	74
Present	47	29	26
Residual tumor status*				<0.001		0.003
R0	121	67	64		1.000
R1 plus R2	14	0	0		3.306 (1.519-7.195)

*According to the AJCC cancer staging manual (7th edition)[8].
†Includes 13 with paraaortic nodal disease.
CI, confidence interval; pT classification, pathological primary tumor classification; pN classification, pathological regional lymph nodes classification; pM classification, pathological distant metastasis classification; G1, well differentiated; G2, moderately differentiated; G3, poorly differentiated; G4, undifferentiated; L0, no lymphatic vessel invasion; L1, lymphatic vessel invasion; V0, no venous invasion; V1, microscopic venous invasion; R0, no residual tumor; R1, microscopic residual tumor; R2, macroscopic residual tumor.

ISSN: 1477-7819