Extended Lymphadenectomy is Associated with Better Survival Outcome in Resected T1b-T4 Gallbladder Cancer: A 505-Patient Cohort Study.

Authors

Tianhao Chen, Yanwen Jin, Junke Wang, Jie Zhang, Qianbin Jia, Fuyu Li, Rongxing Zhou, Wenjie Ma

Published in

Annals of surgical oncology. Oct 07, 2026. Epub Oct 07, 2026.

Abstract

The 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.
This 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.
Compared 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).
Extended 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.

PMID:
42844529
Bibliographic data and abstract were imported from PubMed on 08 Oct 2026.

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