Risk factors of lymphatic metastasis complement poor radiological detection in gallbladder cancer

Table 1 Patient demographics (n = 63)

Characteristic	Value
Median age (range)	62 (39-81)
Gender
Male/female	23/40
Types of radical resection1
Normal radical resection
C alone	61
C + WR + N	38
C + WR + N + BD	7
Extensive resection
C + WR + N + resection of the transverse colon	3
C + right hemihepatectomy + N	3
HPD	6

¹6 patients staged as T1aN0M0 only received cholecystectomy. C: Cholecystectomy; WR: Hepatic wedge resection (thickness as 2-3 cm); BD: Resection of the common bile duct; N: Radical lymphadenectomy; HPD: Hepatopancreaticoduodenectomy.

Table 2 Results of pathological examination (n = 63)

Characteristic	Value
AJCC stage1
Stage I	10
Stage II	14
Stage IIIA	7
Stage IIIB	30
Stage IVA	2
Histologic grade
Grade 1	22
Grade 2	22
Grade 3	17
Grade 4	2
Lymph node dissection
Median number of dissected lymph nodes (range)	6 (0-20)
Patients with LM	32
Median number of positive lymph nodes in patients with LM (range)	2 (1-7)

¹According to American Joint Committee on Cancer (AJCC) staging system (7^th, 2010), Stage I was defined as T1N0M0, Stage II as T2N0M0, Stage IIIA as T3N0M0, Stage IIIB as T1-3N1M0, Stage IVA as T4N0-1M0. LM: Lymphatic metastasis.

Table 3 Correlations between preoperative factors and lymphatic metastasis (n = 63)

Variable	No-LM (n = 31)	LM (n = 32)	Univariate	Multivariate
			P value	OR	95%CI	Pvalue
Age			0.015a	6.240	1.66-22.41	0.007a
< 60 yr (n = 28)	9	19
≥ 60 yr (n = 35)	22	13
Gender			0.082	2.532	0.70-9.28	0.155
Male (n = 23)	8	15
Female (n = 40)	23	17
Jaundice			0.062	3.100	0.59-16.32	0.182
Present (n = 12)	3	9
Absent (n = 51)	28	23
CA 19-9 elevation			0.014a	5.700	1.48-22.00	0.011a
Present (n = 26)	8	18
Absent (n = 37)	23	14
CA 125 elevation			0.165
Present (n = 9)	2	7
Absent (n = 54)	29	25
CEA elevation			0.805
Present (n = 13)	6	7
Absent (n = 50)	25	25
Adjacent organ invasion at CT imaging			0.476
Present (n = 21)	9	12
Absent (n = 42)	22	20
Dilatation of the common bile duct at CT imaging			0.784
Present (n = 11)	5	6
Absent (n = 52)	26	26

^aP < 0.05 between lymphatic metastasis (LM) and no-LM groups. CA: Carbohydrate antigen; CEA: Carcinoembryonic antigen; CT: Computed tomography.

Table 4 Correlations between preoperative factors and number of positive lymph nodes (n = 32)

Variable	1 or 2 positive lymph nodes (n = 20)	3 or more positive lymph nodes (n = 12)	Univariate	Multivariate
			P value	OR	95%CI	P value
Age			0.033a	3.41	1.17-9.92	0.025a
< 60 yr (n = 28)	9	10
≥ 60 yr (n = 35)	11	2
Gender			0.043a	2.36	0.78-7.20	0.129
Male (n = 23)	14	4
Female (n = 40)	6	8
Jaundice			0.361
Present (n = 12)	16	7
Absent (n = 51)	4	5
CA 19-9 elevation			0.198
Present (n = 26)	13	5
Absent (n = 37)	7	7
CA 125 elevation			0.320
Present (n = 9)	6	1
Absent (n = 54)	14	11
CEA elevation			0.740
Present (n = 13)	16	9
Absent (n = 50)	4	3
Adjacent organ invasion at CT imaging			0.642
Present (n = 21)	13	7
Absent (n = 42)	7	5
Dilatation of common bile duct at CT imaging			0.483
Present (n = 11)	15	11
Absent (n = 52)	5	1

^aP < 0.05 between groups. CA: Carbohydrate antigen; CEA: Carcinoembryonic antigen; CT: Computed tomography.

Table 5 Correlations between differentiation type and age, lymphatic metastasis (n = 63)

Differentiation type1	Age < 60 yr (n = 28)	Age≥60 yr (n = 35)	P value (G1 vs G2-4)	No LM	LM	P value (G1 vs G2-4)
G1	9	13	0.679	13	9	0.250
G2-4	19	22		18	23
G2	10	12		10	12
G3	7	10		7	10
G4	2	0		1	1

¹G1 indicates well differentiated, G2 indicates moderately differentiated, and G3 indicates poorly differentiated G4 as undifferentiated. LM: Lymphatic metastasis.