Lymph node yield following cholecystectomy for GB cancer; open versus laparoscopic surgery

Abstract

Background: Surgery serves as the only curative treatment option for patients with GB cancer which has an incidence of approximately 1000 new cases a year within the UK. New evidence suggests that lymph node status serves as a key prognostic factor in the management of GB cancer. No standardised approach or uniform agreement to the extent of lymphadenectomy required for GB cancer management has been determined. The aim of this study was to review our own practice with regard to managing GB cancer, specifically looking at the extent of lymph node harvest when undertaking laparoscopic and open surgery. Material & Methods: A retrospective review of all patients who underwent curative surgery for GB cancer in one institution over 20 years was performed. Patients’ were identified by performing a search through the electronic hospital records using specific ICD10 code. Results: 20 patients were included. The diagnosis of GB cancer was an incidental finding in 14 patients. Surgery with curative intent for GB cancer was performed with open surgery in (n =10) 50% and Laparoscopic in 50% of the cases. All patients were diagnosed with adenocarcinoma on histology. The median lymph node harvest was higher in open surgery when compared to laparoscopic surgery median 6 (range 1-15) vs 2 ( range 0-11) respectively, P=0.009). Three patients also had adjuvant chemotherapy. Conclusion: In our experience open surgery for GB cancer resulted in a greater lymph node yield. However it is likely lymph node number with laparoscopic surgery could be similar in light of the significance of lymph node involvement and prognosis. Future prospective studies are likely to confirm this