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Prognostic Value of Lymph Node Dissection for Intrahepatic Cholangiocarcinoma Patients With Clinically Negative Lymph Node Metastasis: A Multi-Center Study From China

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单位: [1]Fujian Med Univ, Mengchao Hepatobiliary Hosp, Dept Hepatobiliary Surg, Fuzhou, Peoples R China [2]Fujian Med Univ, Fujian Canc Hosp, Sch Clin Med, Dept Radiat Oncol, Fuzhou, Peoples R China [3]Zhejiang Univ, Hosp 2, Dept Hepatobiliary Surg, Hangzhou, Peoples R China [4]Army Med Univ, Southwest Hosp, Dept Hepatobiliary Surg, Chongqing, Peoples R China [5]Chinese Acad Med Sci, Canc Hosp, Dept Hepatobiliary Surg, Beijing, Peoples R China [6]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Dept Hepatobiliary Surg,Wuhan,Peoples R China [7]Capital Med Univ, Beijing Friendship Hosp, Dept Hepatobiliary Surg, Beijing, Peoples R China [8]Sichuan Univ, West China Hosp, Dept Hepatobiliary Surg, Chengdu, Peoples R China [9]Shanghai Jiao Tong Univ, Renji Hosp, Dept Hepatobiliary Surg, Shanghai, Peoples R China [10]Capital Med Univ, Xuanwu Hosp, Dept Hepatobiliary Surg, Beijing, Peoples R China [11]Chuanbei Med Univ, Affiliated Hosp, Dept Hepatobiliary Surg, Nanchong, Peoples R China [12]Capital Med Univ, Tiantan Hosp, Dept Hepatobiliary Surg, Beijing, Peoples R China [13]Secondary Mil Med Univ, Eastern Hepatobiliary Surg Hosp, Dept Hepatobiliary Surg 3, Shanghai, Peoples R China
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关键词: intrahepatic cholangiocarcinoma lymph node dissection node-negative overall survival propensity score matching

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Background The clinical value of lymph-node dissection (LND) for intrahepatic carcinoma (ICC) patients with clinically negative lymph node metastasis (LNM) remains unclear; hence we conducted a multi-center study to explore it. Methods Patients who were diagnosed ICC with clinically negative LNM and underwent hepatectomy with or without LND from December 2012 to December 2015 were retrospectively collected from 12 hepatobiliary centers in China. Overall survival (OS) was analyzed using the Kaplan-Meier method, and then subgroup analysis was conducted stratified by variables related to the prognosis. Results A total of 380 patients were eligible including 106 (27.9%) in the LND group and 274 (72.1%) in the non-LND group. Median OS in the LND group was slightly longer than that in the non-LND group (24.0 vs. 18.0 months, P = 0.30), but a significant difference was observed between the two groups (24.0 vs. 14.0 months, P = 0.02) after a well-designed 1:1 propensity score matching without increased severe complications. And, LND was identified to be one of the independent risk factors of OS (HR = 0.66, 95%CI = 0.46-0.95, P = 0.025). Subgroup analysis in the matched cohort showed that patients could benefit more from LND if they were male, age <60 years, had no HBV infection, with ECOG score <2, CEA <= 5 ug/L, blood loss <= 400 ml, transfusion, major hepatectomy, resection margin >= 1 cm, tumor size >5 cm, single tumor, mass-forming, no satellite, no MVI, and no perineural invasion (all P < 0.05). Furthermore, only patients with pathologically confirmed positive LNM were found to benefit from postoperative adjuvant therapy (P < 0.001). Conclusion With the current data, we concluded that LND would benefit the selected ICC patients with clinically negative LNM and might guide the postoperative management.

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出版当年[2020]版:
大类 | 2 区 医学
小类 | 3 区 肿瘤学
最新[2025]版:
大类 | 3 区 医学
小类 | 4 区 肿瘤学
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出版当年[2019]版:
Q2 ONCOLOGY
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Q2 ONCOLOGY

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第一作者单位: [1]Fujian Med Univ, Mengchao Hepatobiliary Hosp, Dept Hepatobiliary Surg, Fuzhou, Peoples R China
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