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Metastasis of primary gallbladder carcinoma in lymph node and liver

机译:原发性胆囊癌在淋巴结和肝转移

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摘要

AIM: To evaluate the patterns with metastasis of gallbladder carcinoma in lymph nodes and liver.METHODS: A total of 45 patients who had radical surgery were selected. The patterns with metastasis of primary gallbladder carcinoma in lymph nodes and liver were examined histopathologically and classified as TNM staging of the American Joint Committee on Cancer.RESULTS: Of the 45 patients, 29 (64.4%) had a lymph node positive disease and 20 (44.4%) had a direct invasion of the liver. The frequency of involvement of lymph nodes was strongly influenced by the depth of the primary tumor (P = 0.0001). The postoperative survival rate of patients with negative lymph node metastasis was significantly higher than that of patients with positive lymph node metastasis (P = 0.004), but the postoperative survival rate of patients with N1 lymph node metastasis was not significantly different from that of patients with N2 lymph node metastasis (P = 0.3874). The postoperative survival rate of patients without hepatic invasion was significantly better than that of patients with hepatic invasion (P = 0.0177).CONCLUSION: Complete resection of the regional lymph nodes is important in advanced primary gallbladder carcinoma (PGC). The initial sites of liver spread are located mostly in segments IV and V. It is necessary to achieve negative surgical margins 2 cm from the tumor. In patients with hepatic hilum invasion, extended right hepatectomy with or without bile duct resection or portal vein resection is necessary for curative resection.
机译:目的:评价胆囊癌在淋巴结和肝中的转移方式。方法:选择45例行根治性手术的患者。组织病理学检查了原发性胆囊癌在淋巴结和肝脏中的转移模式,归类为美国癌症联合委员会的TNM分期。结果:45例患者中,有29例(64.4%)淋巴结阳性,其中20例44.4%)直接侵袭了肝脏。淋巴结受累的频率受到原发肿瘤深度的强烈影响(P = 0.0001)。淋巴结转移阴性的患者术后生存率明显高于阳性淋巴结转移的患者(P = 0.004),但N1淋巴结转移患者的术后生存率与恶性淋巴结转移的患者无明显差异。 N2淋巴结转移(P = 0.3874)。无肝浸润患者的术后生存率明显高于有肝浸润患者(P = 0.0177)。结论:区域淋巴结的完全切除对于晚期原发性胆囊癌(PGC)很重要。肝脏扩散的最初部位主要位于IV和V段。必须在距肿瘤2 cm处达到负手术切缘。对于肝门侵犯的患者,对于根治性切除术,无论有无胆管切除或门静脉切除,均需行右肝切除术。

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