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MIB-1, and the argyrophilic nucleolar organizer regions (AgNOR) and examined the relationships among them in carcinoma of the extrahepatic bile duct (EHBD). Shin-ichi RESULTS. MIB-1 and AgNOR were closely associated with lymph node metastasisIwate Medical University, Morioka, Japan.(P õ 0.01). The cumulative survival rate for patients with a low MIB-1 labeling index (LI) (õ29%) was significantly better than that for patients with a high MIB-2 Division of Pathology, Central Clinical Laboratory, School of Medicine, Iwate Medical Univer-1 LI (¢29%) in cases of EHBD carcinoma (P õ 0.05), but MIB-1 was not an indepensity, Morioka, Japan. dent prognostic factor in multivariate analysis. The results indicated that AgNOR and p53 overexpression had no prognostic value. The authors detected p53 in 24 of the 54 EHBD carcinomas (44.4%). There was a significant correlation between MIB-1 and AgNOR (P õ 0.01). The authors found that neither MIB-1 nor AgNOR correlated with p53 overexpression. CONCLUSIONS. MIB-1 and

The present study aimed to clarify the efficacy of extensive surgery, including pancreas head resection, for more complete lymphadenectomy in the treatment of gallbladder carcinoma. The study involved retrospective analyses of 65 consecutive patients with gallbladder carcinoma who underwent surgical resection between 1982 and 2003. Of these 65 patients, 41.5% displayed node-positive disease and among them 23.1% had positive para-aortic nodes. Of six node-positive 5-year survivors, five underwent pancreatoduodenectomy combined with S4aS5 hepatic subsegmentectomy. The 5-year survival rates were 76.2% for pN0, 30.0% for pN1, 45.8% for pN2, and 0% for pM1[lymph], respectively. Significant differences existed in survival rates. Postoperative recurrence was observed in 24.1% (13/54) of patients who underwent R0 resection. Of the four patients who displayed lymph node recurrence, two had pericholedocal and/or posterior pancreatoduodenal lymph node metastasis at the time of surgery and underwent pancreas-preserving regional lymphadenectomy. These results suggest that extensive resection, including resection of the pancreatic head, is effective in selected patients with up to pN2 lymph node metastasis, as long as complete removal of the cancer can be achieved. Pancreatoduodenectomy combined with S4aS5 hepatic subsegmentectomy should be considered when lymph node metastasis is obvious and the patient is in good condition.

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