The influence of the extent of lymph node metastasis on the prognosis for patients with intrahepatic cholangiocarcinoma

Jianping Wang; Man Shu; Hong Peng; Shaoqiang Li; Dongming Li; Jingxian Shen; Ming Kuang; Ying Zhang; Zebin Chen

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자료유형: 학술저널

저자정보: Jianping Wang (Sun Yat-sen University) Man Shu (Sun Yat-sen University) Hong Peng (Sun Yat-sen University) Shaoqiang Li (Sun Yat-sen University) Dongming Li (Sun Yat-sen University) Jingxian Shen (Sun Yat-sen University Cancer Center) Ming Kuang (Sun Yat-sen University) Ying Zhang (Sun Yat-sen University) Zebin Chen (Sun Yat-sen University)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.104 No.5

발행연도: 2023.5

수록면: 258 - 268 (11page)

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Purpose: Reports showed that some of intrahepatic cholangiocarcinoma (ICC) patients with lymph node metastasis (LNM) may also gain survival benefit undergone resection. However, the effect of the extent of LNM on prognosis and surgical indication is barely discussed.
Methods: From September 1994 to November 2018, primary ICC patients undergone initial curable surgery were enrolled. Based on the extent of LNM, we divided these patients into 4 groups, including patients with no LNM (group N0), LNM to hepatoduodenal ligament or common hepatic artery (region A, group A), LNM to gastrohepatic lymph nodes for left liver ICC and periduodenal and peripancreatic lymph node for right liver ICC (region B, group B), or LNM beyond these regions (region C, group C). Multivariable Cox regression analysis was performed to identify the prognostic factors for recurrencefree survival (RFS) and overall survival (OS) in all groups.
Results: A total of 133 patients were enrolled. There were 56, 21, 17, and 39 patients in groups N0, A, B, and C, respectively. There was significant difference between groups N0 and C in RFS (P ＜ 0.001) and OS (P = 0.002). When we compared group N0 + A + B with group C, we also found that RFS (P ＜ 0.001) and OS (P = 0.007) were significantly different. In multivariable analysis, the extent of LNM was an independent risk factor for RFS (P ＜ 0.050).
Conclusion: ICC patients with the LNM to regions A and B could still achieve good prognosis with resection. Surgery should be carefully considered when LNM to region C.

#Cholangiocarcinoma #Lymphatic metastasis #Surgery

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