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01-11-2020 | Metastasis | Original Article

Invasion category-oriented lymph node metastases of cholangiocarcinoma and the prognostic impact

Authors: Shogo Kobayashi, Hiroshi Wada, Akira Tomokuni, Hidenori Takahashi, Kunihito Gotoh, Masato Sakon, Masaki Mori, Yuichiro Doki, Hidetoshi Eguchi

Published in: Langenbeck's Archives of Surgery | Issue 7/2020

Abstract

Purpose

It was speculated that intrahepatic cholangiocarcinoma (ICC) invasion would influence cancer progression, such as lymph node (LN) metastasis, and the efficacy of LN dissection (LND). The purpose of this study is to evaluate the LN metastatic pattern of intrahepatic cholangiocarcinoma, including the invasion category and prognosis after surgical resection, in order to explore effective LND.

Methods

We analyzed a prospectively collected cohort for ICC with a previously reported invasion category: hilar type, showing invasion to the main or first branch of Glisson; peripheral type, showing no invasion to less than the third branch; and intermediate type, for all others.

Results

Data from a total of 180 patients who underwent surgical resection were analyzed (LN dissection in 142 (79%)). In single ICC, hilar type had a higher LN metastatic rate than the others (hilar; 23/45 (51%), intermediate; 7/25 (28%), peripheral; 1/34 (3%)). Although the survival with LN metastasis (LN+) was worse, single and hilar/intermediate ICC LN+ had a better survival than peripheral type LN+ (3-year OS: hilar/intermediate 30–37%, peripheral 0%). The most frequent LN metastatic region was the hepatico-duodenal ligament for all invasion categories, and the LN metastatic region was not related to the survival. In peripheral ICC, LND did not affect the survival. By contrast, hilar/intermediate ICC LN+ had a better survival than did peripheral ICC LN+, and the 3-year OS was ≥ 20%.

Conclusion

LN metastasis depended on the ICC invasion category in addition to the tumor number, which affected patients’ survival and the need for LND. In hilar-type disease, LN dissection may contribute to the survival.

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Title: Invasion category-oriented lymph node metastases of cholangiocarcinoma and the prognostic impact
Authors: Shogo Kobayashi
Hiroshi Wada
Akira Tomokuni
Hidenori Takahashi
Kunihito Gotoh
Masato Sakon
Masaki Mori
Yuichiro Doki
Hidetoshi Eguchi
Publication date: 01-11-2020
Publisher: Springer Berlin Heidelberg
Keywords: Metastasis
Cholangiocarcinoma
Cholangiocarcinoma
Published in: Langenbeck's Archives of Surgery / Issue 7/2020
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-020-01955-3

At a glance: The STEP trials

Springer Medicine

Invasion category-oriented lymph node metastases of cholangiocarcinoma and the prognostic impact

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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