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Open versus laparoscopic portal lymphadenectomy in gallbladder cancer: is there a difference in lymph node yield?

Publication ,  Journal Article
Ong, CT; Leung, K; Nussbaum, DP; Sun, Z; Gloor, B; Blazer, DG; Worni, M
Published in: HPB (Oxford)
June 2018

BACKGROUND: Gallbladder cancer (GBC) is the most common biliary tract malignancy. Because it commonly metastasizes via lymphatics, portal lymphadenectomy should be included in oncologic resections. This study aimed to compare the oncologic equivalence of the laparoscopic versus open technique by evaluating lymph node (LN) yield. METHODS: The 2010-2012 National Cancer Data Base identified patients who underwent laparoscopic or open resection of GBC with dedicated lymphadenectomy. LN yield was compared by resection method. Variables associated with LN yield ≥3 were identified. RESULTS: Of 1524 patients identified, 52% were intended to undergo laparoscopic surgery, with 20% of these patients converted to open. Collection of ≥3 LNs following open resection (47%) was higher than for laparoscopic resection (34%), p < 0.001. Operations performed at high-volume (aOR:1.74, p < 0.001) and/or academic centers (aOR:1.70, p = 0.024) had superior LN yield. LN yield was not associated with overall survival (aHR:0.93, p = 0.493). CONCLUSIONS: In this analysis of national data, LN yield following laparoscopic resection for GBC was significantly lower than following open resection. Open resection is more frequently performed at academic centers, possibly to assure adequate oncologic resection. Enforcing consensus guidelines for lymphadenectomy in gallbladder cancer will optimize outcomes as minimally invasive approaches evolve.

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Published In

HPB (Oxford)

DOI

EISSN

1477-2574

Publication Date

June 2018

Volume

20

Issue

6

Start / End Page

505 / 513

Location

England

Related Subject Headings

  • United States
  • Treatment Outcome
  • Surgery
  • Risk Factors
  • Retrospective Studies
  • Neoplasm Staging
  • Neoplasm Grading
  • Middle Aged
  • Male
  • Lymphatic Metastasis
 

Citation

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Ong, C. T., Leung, K., Nussbaum, D. P., Sun, Z., Gloor, B., Blazer, D. G., & Worni, M. (2018). Open versus laparoscopic portal lymphadenectomy in gallbladder cancer: is there a difference in lymph node yield? HPB (Oxford), 20(6), 505–513. https://doi.org/10.1016/j.hpb.2017.10.015
Ong, Cecilia T., Kenneth Leung, Daniel P. Nussbaum, Zhifei Sun, Beat Gloor, Dan G. Blazer, and Mathias Worni. “Open versus laparoscopic portal lymphadenectomy in gallbladder cancer: is there a difference in lymph node yield?HPB (Oxford) 20, no. 6 (June 2018): 505–13. https://doi.org/10.1016/j.hpb.2017.10.015.
Ong CT, Leung K, Nussbaum DP, Sun Z, Gloor B, Blazer DG, et al. Open versus laparoscopic portal lymphadenectomy in gallbladder cancer: is there a difference in lymph node yield? HPB (Oxford). 2018 Jun;20(6):505–13.
Ong, Cecilia T., et al. “Open versus laparoscopic portal lymphadenectomy in gallbladder cancer: is there a difference in lymph node yield?HPB (Oxford), vol. 20, no. 6, June 2018, pp. 505–13. Pubmed, doi:10.1016/j.hpb.2017.10.015.
Ong CT, Leung K, Nussbaum DP, Sun Z, Gloor B, Blazer DG, Worni M. Open versus laparoscopic portal lymphadenectomy in gallbladder cancer: is there a difference in lymph node yield? HPB (Oxford). 2018 Jun;20(6):505–513.
Journal cover image

Published In

HPB (Oxford)

DOI

EISSN

1477-2574

Publication Date

June 2018

Volume

20

Issue

6

Start / End Page

505 / 513

Location

England

Related Subject Headings

  • United States
  • Treatment Outcome
  • Surgery
  • Risk Factors
  • Retrospective Studies
  • Neoplasm Staging
  • Neoplasm Grading
  • Middle Aged
  • Male
  • Lymphatic Metastasis