Conundrum of station 13 lymph nodes in Gallbladder Carcinoma: Retrospective tryst with a forgotten entity

Gallbladder cancers are one of the lethal cancers with dismal prognosis. There is discrepancy between various biliary societies regarding extent of regional lymph nodes of gallbladder. Some consider station 13 as regional nodes, whereas others consider it as distant metastatic node. This is a retrospective analysis of disease-free survival of stage IIIB and IVB-M0 patients in gall bladder cancer with positive station 13 lymph node. Electronic medical records of patients were used to retrieve the data. The mean and median disease-free survival of gallbladder carcinoma patients with station 13 lymph-node positivity is 16.2 months (95% CI 11.57-20.85 months) and 12 months (95% CI 9.57-14.43 months), respectively. Disease-free survival of Stage IIIB and IVB-M0 gallbladder carcinoma patients with station 13 lymph-node positivity is better than overall survival of stage IVB-M1 patients and supports the inclusion of station 13 lymph node as regional lymph-nodal basin of gall bladder carcinoma. This study paves the way for a large prospective study to consider station 13 lymph node as regional lymph node in gallbladder cancer.