Assessment of the Lymph Node Status in Patients Undergoing Liver Resection for Intrahepatic Cholangiocarcinoma: the New Eighth Edition AJCC Staging System
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Publication Date: | 2018 |
Other Authors: | , , , , , , , , , , , , , , , |
Format: | Article |
Language: | eng |
Source: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Download full: | http://hdl.handle.net/10400.17/3205 |
Summary: | INTRODUCTION: The role of routine lymphadenectomy for intrahepatic cholangiocarcinoma (ICC) is still controversial. The AJCC eighth edition recommends a minimum of six harvested lymph nodes (HLNs) for adequate nodal staging. We sought to define outcome and risk of death among patients who were staged with ≥6 HLNs versus <6 HLNs. MATERIALS AND METHODS: Patients undergoing hepatectomy for ICC between 1990 and 2015 at 1 of the 14 major hepatobiliary centers were identified. RESULTS: Among 1154 patients undergoing hepatectomy for ICC, 515 (44.6%) had lymphadenectomy. On final pathology, 200 (17.3%) patients had metastatic lymph node (MLN), while 315 (27.3%) had negative lymph node (NLN). Among NLN patients, HLN was associated with 5-year OS (p = 0.098). While HLN did not impact 5-year OS among MLN patients (p = 0.71), the number of MLN was associated with 5-year OS (p = 0.02). Among the 317 (27.5%) patients staged according the AJCC eighth edition staging system, N1 patients had a 3-fold increased risk of death compared with N0 patients (hazard ratio 3.03; p < 0.001). CONCLUSION: Only one fourth of patients undergoing hepatectomy for ICC had adequate nodal staging according to the AJCC eighth edition. While the six HLN cutoff value impacted prognosis of N0 patients, the number of MLN rather than HLN was associated with long-term survival of N1 patients. |
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Assessment of the Lymph Node Status in Patients Undergoing Liver Resection for Intrahepatic Cholangiocarcinoma: the New Eighth Edition AJCC Staging SystemHCC CIRICCBile Duct Neoplasms/pathologyBile Duct Neoplasms/surgeryBile Ducts, IntrahepaticCholangiocarcinoma/secondaryCholangiocarcinoma/surgeryHepatectomyLymph Node ExcisionLymph Nodes/pathologyLymph Nodes/surgeryLymphatic MetastasisPrognosisSurvival RateNeoplasm StagingProportional Hazards ModelsINTRODUCTION: The role of routine lymphadenectomy for intrahepatic cholangiocarcinoma (ICC) is still controversial. The AJCC eighth edition recommends a minimum of six harvested lymph nodes (HLNs) for adequate nodal staging. We sought to define outcome and risk of death among patients who were staged with ≥6 HLNs versus <6 HLNs. MATERIALS AND METHODS: Patients undergoing hepatectomy for ICC between 1990 and 2015 at 1 of the 14 major hepatobiliary centers were identified. RESULTS: Among 1154 patients undergoing hepatectomy for ICC, 515 (44.6%) had lymphadenectomy. On final pathology, 200 (17.3%) patients had metastatic lymph node (MLN), while 315 (27.3%) had negative lymph node (NLN). Among NLN patients, HLN was associated with 5-year OS (p = 0.098). While HLN did not impact 5-year OS among MLN patients (p = 0.71), the number of MLN was associated with 5-year OS (p = 0.02). Among the 317 (27.5%) patients staged according the AJCC eighth edition staging system, N1 patients had a 3-fold increased risk of death compared with N0 patients (hazard ratio 3.03; p < 0.001). CONCLUSION: Only one fourth of patients undergoing hepatectomy for ICC had adequate nodal staging according to the AJCC eighth edition. While the six HLN cutoff value impacted prognosis of N0 patients, the number of MLN rather than HLN was associated with long-term survival of N1 patients.SpringerRepositório do Centro Hospitalar Universitário de Lisboa Central, EPEBagante, FSpolverato, GWeiss, MAlexandrescu, SPinto Marques, HAldrighetti, LMaithel, SKPulitano, CBauer, TWShen, FPoultsides, GASoubrane, OMartel, GGroot Koerkamp, BGuglielmi, AItaru, EPawlik, TM2019-03-21T10:17:55Z20182018-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/3205engJ Gastrointest Surg. 2018 Jan;22(1):52-59.10.1007/s11605-017-3426-xinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:41:48Zoai:repositorio.chlc.min-saude.pt:10400.17/3205Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:20:32.014778Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Assessment of the Lymph Node Status in Patients Undergoing Liver Resection for Intrahepatic Cholangiocarcinoma: the New Eighth Edition AJCC Staging System |
title |
Assessment of the Lymph Node Status in Patients Undergoing Liver Resection for Intrahepatic Cholangiocarcinoma: the New Eighth Edition AJCC Staging System |
spellingShingle |
Assessment of the Lymph Node Status in Patients Undergoing Liver Resection for Intrahepatic Cholangiocarcinoma: the New Eighth Edition AJCC Staging System Bagante, F HCC CIR ICC Bile Duct Neoplasms/pathology Bile Duct Neoplasms/surgery Bile Ducts, Intrahepatic Cholangiocarcinoma/secondary Cholangiocarcinoma/surgery Hepatectomy Lymph Node Excision Lymph Nodes/pathology Lymph Nodes/surgery Lymphatic Metastasis Prognosis Survival Rate Neoplasm Staging Proportional Hazards Models |
title_short |
Assessment of the Lymph Node Status in Patients Undergoing Liver Resection for Intrahepatic Cholangiocarcinoma: the New Eighth Edition AJCC Staging System |
title_full |
Assessment of the Lymph Node Status in Patients Undergoing Liver Resection for Intrahepatic Cholangiocarcinoma: the New Eighth Edition AJCC Staging System |
title_fullStr |
Assessment of the Lymph Node Status in Patients Undergoing Liver Resection for Intrahepatic Cholangiocarcinoma: the New Eighth Edition AJCC Staging System |
title_full_unstemmed |
Assessment of the Lymph Node Status in Patients Undergoing Liver Resection for Intrahepatic Cholangiocarcinoma: the New Eighth Edition AJCC Staging System |
title_sort |
Assessment of the Lymph Node Status in Patients Undergoing Liver Resection for Intrahepatic Cholangiocarcinoma: the New Eighth Edition AJCC Staging System |
author |
Bagante, F |
author_facet |
Bagante, F Spolverato, G Weiss, M Alexandrescu, S Pinto Marques, H Aldrighetti, L Maithel, SK Pulitano, C Bauer, TW Shen, F Poultsides, GA Soubrane, O Martel, G Groot Koerkamp, B Guglielmi, A Itaru, E Pawlik, TM |
author_role |
author |
author2 |
Spolverato, G Weiss, M Alexandrescu, S Pinto Marques, H Aldrighetti, L Maithel, SK Pulitano, C Bauer, TW Shen, F Poultsides, GA Soubrane, O Martel, G Groot Koerkamp, B Guglielmi, A Itaru, E Pawlik, TM |
author2_role |
author author author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Bagante, F Spolverato, G Weiss, M Alexandrescu, S Pinto Marques, H Aldrighetti, L Maithel, SK Pulitano, C Bauer, TW Shen, F Poultsides, GA Soubrane, O Martel, G Groot Koerkamp, B Guglielmi, A Itaru, E Pawlik, TM |
dc.subject.por.fl_str_mv |
HCC CIR ICC Bile Duct Neoplasms/pathology Bile Duct Neoplasms/surgery Bile Ducts, Intrahepatic Cholangiocarcinoma/secondary Cholangiocarcinoma/surgery Hepatectomy Lymph Node Excision Lymph Nodes/pathology Lymph Nodes/surgery Lymphatic Metastasis Prognosis Survival Rate Neoplasm Staging Proportional Hazards Models |
topic |
HCC CIR ICC Bile Duct Neoplasms/pathology Bile Duct Neoplasms/surgery Bile Ducts, Intrahepatic Cholangiocarcinoma/secondary Cholangiocarcinoma/surgery Hepatectomy Lymph Node Excision Lymph Nodes/pathology Lymph Nodes/surgery Lymphatic Metastasis Prognosis Survival Rate Neoplasm Staging Proportional Hazards Models |
description |
INTRODUCTION: The role of routine lymphadenectomy for intrahepatic cholangiocarcinoma (ICC) is still controversial. The AJCC eighth edition recommends a minimum of six harvested lymph nodes (HLNs) for adequate nodal staging. We sought to define outcome and risk of death among patients who were staged with ≥6 HLNs versus <6 HLNs. MATERIALS AND METHODS: Patients undergoing hepatectomy for ICC between 1990 and 2015 at 1 of the 14 major hepatobiliary centers were identified. RESULTS: Among 1154 patients undergoing hepatectomy for ICC, 515 (44.6%) had lymphadenectomy. On final pathology, 200 (17.3%) patients had metastatic lymph node (MLN), while 315 (27.3%) had negative lymph node (NLN). Among NLN patients, HLN was associated with 5-year OS (p = 0.098). While HLN did not impact 5-year OS among MLN patients (p = 0.71), the number of MLN was associated with 5-year OS (p = 0.02). Among the 317 (27.5%) patients staged according the AJCC eighth edition staging system, N1 patients had a 3-fold increased risk of death compared with N0 patients (hazard ratio 3.03; p < 0.001). CONCLUSION: Only one fourth of patients undergoing hepatectomy for ICC had adequate nodal staging according to the AJCC eighth edition. While the six HLN cutoff value impacted prognosis of N0 patients, the number of MLN rather than HLN was associated with long-term survival of N1 patients. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018 2018-01-01T00:00:00Z 2019-03-21T10:17:55Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/3205 |
url |
http://hdl.handle.net/10400.17/3205 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
J Gastrointest Surg. 2018 Jan;22(1):52-59. 10.1007/s11605-017-3426-x |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Springer |
publisher.none.fl_str_mv |
Springer |
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reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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