Impact of lymph node status in patients with intrahepatic cholangiocarcinoma treated by major hepatectomy: a review of the National Cancer Database.

Autor:	Jutric Z; Hepatobiliary and Pancreatic Surgery Program, Providence Cancer Center, Portland, OR, USA., Johnston WC; Hepatobiliary and Pancreatic Surgery Program, Providence Cancer Center, Portland, OR, USA., Hoen HM; Hepatobiliary and Pancreatic Surgery Program, Providence Cancer Center, Portland, OR, USA., Newell PH; Hepatobiliary and Pancreatic Surgery Program, Providence Cancer Center, Portland, OR, USA., Cassera MA; Hepatobiliary and Pancreatic Surgery Program, Providence Cancer Center, Portland, OR, USA., Hammill CW; Hepatobiliary and Pancreatic Surgery Program, Providence Cancer Center, Portland, OR, USA; Providence Cancer Center, Portland, OR, USA; Gastrointestinal and Minimally Invasive Surgery Division, The Oregon Clinic, Portland, OR, USA., Wolf RF; Hepatobiliary and Pancreatic Surgery Program, Providence Cancer Center, Portland, OR, USA; Providence Cancer Center, Portland, OR, USA; Gastrointestinal and Minimally Invasive Surgery Division, The Oregon Clinic, Portland, OR, USA., Hansen PD; Hepatobiliary and Pancreatic Surgery Program, Providence Cancer Center, Portland, OR, USA; Providence Cancer Center, Portland, OR, USA; Gastrointestinal and Minimally Invasive Surgery Division, The Oregon Clinic, Portland, OR, USA. Electronic address: phansen@orclinic.com.
Jazyk:	angličtina
Zdroj:	HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2016 Jan; Vol. 18 (1), pp. 79-87.
DOI:	10.1016/j.hpb.2015.07.006
Abstrakt:	Introduction: Routine lymphadenectomy in the surgical treatment of intrahepatic cholangiocarcinoma (ICC) is not routinely performed. We aim to define predictive indicators of survival in patients with positive lymph nodes. Methods: The National Cancer Data Base (NCDB) was queried for patients who underwent major hepatectomy for ICC between 1998 and 2011. Clinical and pathologic data were assessed using uni- and multi-variate analyses. A sub-analysis was performed on the 160 patients with positive lymph nodes. Results: Of 849 patients with lymph node data, 57% had at least one lymph node examined. Median survival for lymph node negative patients was 37 months versus 15 months for lymph node positive patients. In lymph node positive patients, poorer survival was associated with not receiving chemotherapy (HR 1.83, p = 0.003), tumor size > 5 cm (p = 0.029), and older age (p < 0.0001). Lymph node positive patients age less than 45 had a median survival of 27 months. Conclusions: Overall survival in patients with lymph node metastases from ICC is poor. Adjuvant therapy was associated with a longer survival in lymph node positive patients, although prospective data are needed. Routine lymphadenectomy should be strongly considered to provide prognostic information and guidance for adjuvant therapy. (Copyright © 2015 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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