Prognostic Impact of Paraaortic Lymph Node Metastasis in Extrahepatic Cholangiocarcinoma
- PDF / 410,529 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 0 Downloads / 237 Views
ORIGINAL SCIENTIFIC REPORT
Prognostic Impact of Paraaortic Lymph Node Metastasis in Extrahepatic Cholangiocarcinoma Nobuhito Nitta1 • Katsuhisa Ohgi1 • Teiichi Sugiura1 • Yukiyasu Okamura1 • Takaaki Ito1 • Yusuke Yamamoto1 • Ryo Ashida1 • Shimpei Otsuka1 • Keiko Sasaki2 • Katsuhiko Uesaka1
Accepted: 11 October 2020 Ó Socie´te´ Internationale de Chirurgie 2020
Abstract Background Surgical resection in patients with extrahepatic cholangiocarcinoma (EHCC) with paraaortic lymph node metastasis (PALNM) remains controversial. The objective of this study was to investigate the prognostic impact of PALNM in resected EHCC. Methods The present retrospective study included 410 patients, including 16 patients with PALNM, who underwent surgical resection of EHCC between September 2002 and December 2018. These were compared to 9 patients in whom EHCC was not resected due to PALNM. The clinicopathological features and survival outcomes were investigated to identify the prognostic factors in resected EHCC. Results The overall survival in the resected patients with PALNM was significantly better than that in unresected patients (median survival time [MST] 33.7 vs. 16.7 months, p=0.009) and was not significantly worse than that of patients with regional lymph node metastasis (LNM) (MST 33.7 vs 36.0 months, p=0.278). The multivariate analysis identified age [ 70 years, male sex, tumor location (perihilar), residual tumor status, histological grade, microscopic venous invasion, and regional LNM as independent prognostic factors. Conclusions There was no significant difference in survival between the resected patients with PALNM and patients with regional LNM, and PALNM was not a significant prognostic factor in the multivariate analysis. Surgical resection may be considered an acceptable approach for EHCC with PALNM in selected patients.
Introduction Cholangiocarcinoma most commonly occurs in Asian countries, and the prevalence and number of deaths due to cholangiocarcinoma are increasing [1, 2]. Surgical resection for extrahepatic cholangiocarcinoma (EHCC, including perihilar and distal cholangiocarcinoma) only offers the & Katsuhisa Ohgi [email protected] 1
Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, 1007, Shimo-Nagakubo, Sunto- Nagaizumi, Shizuoka 4118777, Japan
2
Division of Diagnostic Pathology, Shizuoka Cancer Center, Shizuoka, Japan
chance of cure. However, the survival outcomes of patients with EHCC remains poor due to prognostic factors such as nodal metastasis [3–6] or positive resection margins [4–6]. The rate of regional lymph node metastasis (LNM) in EHCC was reported to be 40–53% [3–5, 7], and LNM has been established as a critical prognostic factor [3–6]. Although the relationships between the number of LNMs, site, metastasis rate, and prognosis have been reported, the best strategy for EHCC with LNM is still unclear [5] [8]. The paraaortic lymph nodes (PALNs) are the final nodes in the abdominal lymphatic system from the biliary duct [9, 10]. Paraaortic lymph node metastasis (PALNM) is
Data Loading...
