Retroperitoneal lymph node metastasis in gallbladder cancer: As bad as distant metastasis

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AHBPSAnnals of Hepato-Biliary-Pancreatic Surgery

www.ahbps.org S324

Retroperitoneal lymph node metastasis in gallbladder cancer: As bad as distant metastasis

Ashish SINGH*, Nalini Kanta GHOSH, Rahul RAHUL, Vinay Kumar KAPOOR, Rajan SAXENA Department of Surgical Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India

EP-126

Introduction: Gallbladder cancer (GBC) is the most common biliary tract malignancy. There is conflicting evidence in literature regarding curative surgery in presence of retroperitoneal lymph nodal (interaorto-caval and para-aortic) metastasis. This is a study of patients, in whom a curative resection was abandoned due to the presence of retroperitoneal lymph node metastasis (RLNM) or distant metastasis (DM), to see the effect of RLNM on survival of the GBC patients.

Methods: A retrospective analysis of the patients with GBC found to have RLNM or DM on frozen section biopsy at surgery, between January 2013 and December 2018. Data was analyzed using the Statistical Package for the Social Sciences (SPSS) software (version 22.0). Survival in these two groups (RLNM and DM) was compared with log rank test. p-value of < 0.05 was considered significant.

Results: 235 patients with ostensibly resectable GBC underwent surgical exploration. The planned curative resection was abandoned in 91 (39%) patients because of RLNM (n = 20, 9%) or DM (n = 71, 30%) on frozen section biopsy. Demographic profile and blood pa- rameters were similar in the two groups. The median survival for RLNM and DM groups were 5 (range 2–26; interquartile range [IQR]

3–11) and 6 (range 2–24; IQR 4–10) months, respectively. No significant difference was documented on log rank test (p = 0.64). There was no 3-year in either group.

Conclusions: RLNM should be considered as DM and every effort should be made to target suspicious RLNM pre-operatively. At sur- gery retroperitoneal lymph nodes should be sampled as a routine for frozen section histological examination to avert a futile exercise.

pISSN: 2508-5778ㆍeISSN: 2508-5859

Ann Hepatobiliary Pancreat Surg 2021;25 Suppl 1:S324 https://doi.org/10.14701/ahbps.EP-126

Corresponding Author: Ashish SINGH ([email protected]) Presenter: Ashish SINGH ([email protected])

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.