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World Journal of Surgery

01-05-2011

Is Para-aortic Lymph Node Metastasis a Contraindication for Radical Resection in Biliary Carcinoma?

Authors: Yoshiaki Murakami, Kenichiro Uemura, Takeshi Sudo, Yasushi Hashimoto, Akira Nakashima, Naru Kondo, Ryutaro Sakabe, Hironori Kobayashi, Taijiro Sueda

Published in: World Journal of Surgery | Issue 5/2011

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Abstract

Background

Para-aortic nodal dissection in patients with biliary carcinoma has not been performed routinely worldwide. Therefore, the prognostic impact of para-aortic lymph node metastasis in biliary carcinoma has not yet been evaluated. The aim of this study was to clarify the prognostic impact of para-aortic lymph node metastasis in biliary carcinoma.

Methods

Of 113 patients with biliary adenocarcinoma who underwent surgical resection with regional and para-aortic lymph node dissection, para-aortic lymph node metastasis was found in 17 patients (15%) by final pathological examination. Relationships between clinicopathological factors, including para-aortic lymph node metastasis, and survival were analyzed by univariate and multivariate analyses.

Results

Overall survival rates for the 113 patients were 82% at 1 year, 65% at 2 years, 58% at 3 years, and 52% at 5 years. Univariate analysis revealed that better tumor differentiation (P = 0.044), negative lymph node metastasis (P < 0.001), negative para-aortic lymph node metastasis (P = 0.007), negative surgical margin status (P < 0.001), lower UICC pT factor (P = 0.009), and earlier UICC stage (P < 0.001) were associated significantly with longer survival. Lymph node metastasis (P = 0.004) but not para-aortic lymph node metastasis (P = 0.323) remained associated independently with longer survival by multivariate analysis. Five-year survival rates for node-negative patients, node-positive patients without para-aortic lymph node metastasis, and node-positive patients with para-aortic lymph node metastasis were 72, 31, and 24%, respectively.

Conclusion

Radical resection should not be abandoned for patients with para-aortic lymph node metastasis in biliary adenocarcinoma.
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Metadata
Title
Is Para-aortic Lymph Node Metastasis a Contraindication for Radical Resection in Biliary Carcinoma?
Authors
Yoshiaki Murakami
Kenichiro Uemura
Takeshi Sudo
Yasushi Hashimoto
Akira Nakashima
Naru Kondo
Ryutaro Sakabe
Hironori Kobayashi
Taijiro Sueda
Publication date
01-05-2011
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 5/2011
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-011-1036-4