Abstract
Introduction: The infiltrative node is a strong prognostic indicator of survival in gallbladder cancer. The profile of the Mascagni ganglion (Ganglion of the neck of the gallbladder) has never been studied and taken into account for the form of histological discovery. The purpose of this retrospective study is to assess the impact of the Mascagni lymph node profile (GGM) and the prediction of the presence of residual tumor tissue after a histological discovery of gallbladder cancer. Material and method: Forty-one patients were collected. Group A (No infiltrated Mascagni node) is made up of 15 patients while group B (infiltrated Mascagni node) is made up of 26 patients. Complementary secondary surgery was retained in 27 patients (65.8%) who underwent complimentary radical surgery in 16 (39%) of them and palliative surgery for 10 others (24,4%). Sixteen patients (39%) did not have secondary surgery. The mean time to reopen was 93.9 (48-166) in group A and 85.6 (21-230) days (p=0.5). Only 2 patients (13.3%) of group A had a residual tumor (carcinomatosis) and 100% of patients of group B presented this residual tumor with or without second surgery (p<0.001). Result: No patient of group A had infiltrated lymph node even after second surgery while 92.3% (24/26) of group B had finally infiltrated lymph node (results of two interventions) (p<0.001). Survival is significantly higher in-group A than in-group B. with global five-year survival reaching 46.6% vs only 03.8%. Free survival is significantly higher for group A than group B (73.3% (11/15) vs 03.8% (3/26). The survival is also significantly higher for both cholecystectomy alone and radical secondary surgery with 62.5% (05/08) vs 00% (00/16) (p < 0.05) and 85.60% (06/07) vs 30% (03/10) respectively (p<0.01). Conclusion: GGM is a strong prognostic factor for gall bladder cancer discovered on the resected specimens. It must be noted systematically on the histological reports and be taken into account before the secondary radical surgery.
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