ArticleAnnals of surgical oncology2026
Extended Lymphadenectomy is Associated with Better Survival Outcome in Resected T1b-T4 Gallbladder Cancer: A 505-Patient Cohort Study.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe optimal extent of lymphadenectomy for gallbladder cancer (GBC) remains controversial. This study evaluated the prognostic impact of regional lymphadenectomy (R-LD) versus extended lymphadenectomy (E-LD) in patients undergoing radical resection for GBC.
methodsThis retrospective cohort study included 505 patients who underwent surgery for GBC at our institution from 2010 to 2022. R-LD included nodes No. 8, 12, and 13, E-LD additionally included nodes No. 9, 14, and 16. Survival and prognostic factors were assessed using Kaplan-Meier curves and Cox regression analyses. Propensity score matching (PSM) was applied to reduce confounding.
resultsCompared with R-LD, E-LD resulted in significantly higher lymph node retrieval (median, 7 vs. 2; P < 0.001) and detection of positive lymph nodes (median, 1 vs. 0; P < 0.001). E-LD was associated with increased postoperative morbidity (34.2% vs. 24.2%; P = 0.020). In the overall cohort, median overall survival was numerically longer with E-LD (19 vs. 15 months) without statistical significance (P = 0.056) , and disease-free survival was comparable (10 vs. 9 months; P = 0.318). Multivariable analysis identified E-LD as independently associated with survival (HR, 0.75; 95% CI, 0.59-0.96; P = 0.024). After propensity score matching, the OS benefit became significant (19 vs. 13 months; P = 0.011).
conclusionsExtended lymphadenectomy improves nodal assessment and staging accuracy in patients with GBC undergoing radical resection and may provide additional oncological benefits. Although associated with increased postoperative morbidity, E-LD can be considered for T1b or higher-stage GBC with careful surgical technique and perioperative management.
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