{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T02:17:24Z","timestamp":1784945844201,"version":"3.55.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T00:00:00Z","timestamp":1721692800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"Background<\/jats:title>Lymph node involvement is recognized as a prognostic factor for patients with gallbladder cancer. However, the N stage varied from different editions of the American Joint Committee on Cancer (AJCC) TNM Classification. Our objective was to investigate the impact of lymph node involvement on overall survival in elderly patients with non-metastatic gallbladder adenocarcinoma.<\/jats:p><\/jats:sec>Methods<\/jats:title>Patients older than 65 years with non-metastatic gallbladder adenocarcinoma were identified from the SEER data. We used Cox proportional hazard regression analysis to select the independent risk factor. A nomogram was built to identify the 1-, 3-, and 5-years\u2019 prognostic impact. Univariate and multivariate models were used to examine the correlation of overall survival (OS) with the number of metastatic nodes.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 1,654 patients (706 with and 948 without nodal involvement) were included. Cox proportional hazard regression analyses found that age, gender, tumor size, lymph node involvement, and surgical options were risk factors for the prognosis and were integrated into the nomogram. After adjustment, OS was compromised for patients who receive surgery with nodal involvement [hazard ratio (HR), 2.238; P<\/jats:italic>\u2009&lt;\u20090.01]. Furthermore, after adjustment the presence of more than two metastatic lymph nodes was associated with decreased OS (HR, 3.305; P<\/jats:italic>\u2009&lt;\u20090.01).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Our results suggest that lymph node involvement is associated with compromised survival in elderly patients. A nomogram was developed to predict the prognosis of gallbladder cancer. A change point of more than two metastatic lymph nodes seems to carry prognostic significance, calling for closer monitoring of elderly patients with gallbladder cancer with involvement of increased number of lymph nodes.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2024.1414870","type":"journal-article","created":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T04:32:16Z","timestamp":1721709136000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Lymph node involvement is associated with overall survival for elderly patients with non-metastatic gallbladder adenocarcinoma"],"prefix":"10.3389","volume":"11","author":[{"given":"Jianhao","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanyu","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuesong","family":"Bai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaodong","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,7,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1309\/AJCPQT3ELN2BBCKA","article-title":"Gallbladder cancer in Chile: pathologic characteristics of survival and prognostic factors: analysis of 1,366 cases","volume":"141","author":"Roa","year":"2014","journal-title":"Am J Clin Pathol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"B3","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3322\/caac.21590","article-title":"Cancer statistics, 2020","volume":"70","author":"Siegel","year":"2020","journal-title":"CA Cancer J Clin"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15205055","article-title":"Prognosis and treatment outcomes of bone metastasis in gallbladder adenocarcinoma: a SEER-based study","volume":"15","author":"Gera","year":"2023","journal-title":"Cancers (Basel)"},{"key":"B5","first-page":"1567","article-title":"Radical surgery for gallbladder cancer. Results of the French Surgical Association Survey","volume":"46","author":"Cubertafond","year":"1999","journal-title":"Hepatogastroenterology"},{"key":"B6","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1038\/s41572-022-00398-y","article-title":"Gallbladder cancer","volume":"8","author":"Roa","year":"2022","journal-title":"Nat Rev Dis Primers"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1489","DOI":"10.1002\/cncr.31942","article-title":"Biliary tract cancer incidence and trends in the United States by demographic group, 1999\u20132013","volume":"125","author":"Van Dyke","year":"2019","journal-title":"Cancer"},{"key":"B8","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1002\/cncr.22815","article-title":"Recent trends of gallbladder cancer in Japan: an analysis of 4,770 patients","volume":"110","author":"Kayahara","year":"2007","journal-title":"Cancer"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1002\/jso.25450","article-title":"The optimal number of lymph nodes to evaluate among patients undergoing surgery for gallbladder cancer: correlating the number of nodes removed with survival in 6,531 patients","volume":"119","author":"Tsilimigras","year":"2019","journal-title":"J Surg Oncol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1471","DOI":"10.1245\/s10434-010-0985-4","article-title":"The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM","volume":"17","author":"Edge","year":"2010","journal-title":"Ann Surg Oncol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"93","DOI":"10.3322\/caac.21388","article-title":"The eighth edition AJCC cancer staging manual: continuing to build a bridge from a population-based to a more \u201cpersonalized\u201d approach to cancer staging","volume":"67","author":"Amin","year":"2017","journal-title":"CA Cancer J Clin"},{"key":"B12","doi-asserted-by":"publisher","first-page":"2370","DOI":"10.1200\/JCO.2014.59.8391","article-title":"Presence and number of lymph node metastases are associated with compromised survival for patients younger than age 45 years with papillary thyroid cancer","volume":"33","author":"Adam","year":"2015","journal-title":"J Clin Oncol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"5167","DOI":"10.3748\/wjg.v24.i45.5167","article-title":"Nomogram to predict overall survival after gallbladder cancer resection in China","volume":"24","author":"Bai","year":"2018","journal-title":"World J Gastroenterol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"3246","DOI":"10.7150\/jca.30046","article-title":"A nomogram for prediction of overall survival in patients with node-negative gallbladder cancer","volume":"10","author":"Chen","year":"2019","journal-title":"J Cancer"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1704","DOI":"10.7150\/ijms.47073","article-title":"A novel nomogram predicting distant metastasis in T1 and T2 gallbladder cancer: a SEER-based study","volume":"17","author":"Cai","year":"2020","journal-title":"Int J Med Sci"},{"key":"B16","doi-asserted-by":"publisher","first-page":"444","DOI":"10.1186\/s12876-022-02544-y","article-title":"A nomogram for predicting cancer-specific survival for elderly patients with gallbladder cancer","volume":"22","author":"Wen","year":"2022","journal-title":"BMC Gastroenterol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1097\/SLA.0b013e31822238d8","article-title":"Accurate staging for gallbladder cancer: implications for surgical therapy and pathological assessment","volume":"254","author":"Ito","year":"2011","journal-title":"Ann Surg"},{"key":"B18","doi-asserted-by":"publisher","first-page":"2886","DOI":"10.3748\/wjg.v24.i26.2886","article-title":"Impact of the number of examined lymph nodes on outcomes in patients with lymph node-negative gallbladder carcinoma","volume":"24","author":"Fan","year":"2018","journal-title":"World J Gastroenterol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1245\/s10434-014-4044-4","article-title":"Lymph node metastases in patients undergoing surgery for a gallbladder cancer. Extension of the lymph node dissection and prognostic value of the lymph node ratio","volume":"22","author":"Birnbaum","year":"2015","journal-title":"Ann Surg Oncol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1007\/s11605-011-1528-4","article-title":"Lymph nodal involvement as prognostic factor in gallbladder cancer: location, count or ratio?","volume":"15","author":"Negi","year":"2011","journal-title":"J Gastrointest Surg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"3016","DOI":"10.1245\/s10434-016-5243-y","article-title":"Prognostic implications of lymph node status for patients with gallbladder cancer: a multi-institutional study","volume":"23","author":"Amini","year":"2016","journal-title":"Ann Surg Oncol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"8142","DOI":"10.1245\/s10434-021-10749-w","article-title":"Optimal lymph node staging system in evaluating prognosis of gallbladder carcinoma: a multi-institutional study","volume":"28","author":"Chen","year":"2021","journal-title":"Ann Surg Oncol"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2024.1414870\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T04:32:19Z","timestamp":1721709139000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2024.1414870\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,23]]},"references-count":22,"alternative-id":["10.3389\/fsurg.2024.1414870"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2024.1414870","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,23]]},"article-number":"1414870"}}