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Cited 8 time in webofscience Cited 9 time in scopus
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Clinical implication of tumor site in terms of node metastasis for intrahepatic cholangiocarcinomaopen access

Authors
Lee, WoohyungJeong, Chi-YoungJang, Jae YoolRoh, Young HoonKim, Kwan WooKang, Sung HwaYoon, Myung HeeSeo, Hyung IlPark, Jeong-IkJung, Bo-HyunShin, Dong HoonChoi, Young IlMoon, Hyung HwanRyu, Je HoYang, KwanghoChoi, Chang SooPark, Yo-HanNah, Yang WonKim, RyounggoNavarro, JonathanHan, Dae-HoonChoi, Gi HongKang, Chang MooKim, Kyung-SikHong, Soon-Chan
Issue Date
May-2020
Publisher
W. B. Saunders Co., Ltd.
Keywords
Intrahepatic cholangiocarcinoma; Tumor site; Lymph node metastasis
Citation
European Journal of Surgical Oncology, v.46, no.5, pp 832 - 838
Pages
7
Indexed
SCIE
SCOPUS
Journal Title
European Journal of Surgical Oncology
Volume
46
Number
5
Start Page
832
End Page
838
URI
https://scholarworks.gnu.ac.kr/handle/sw.gnu/6682
DOI
10.1016/j.ejso.2019.11.511
ISSN
0748-7983
1532-2157
Abstract
Background: The clinical implication of lymph node (LN) dissection of intrahepatic cholangiocarcinoma (ICCA) is still controversial, and LN metastasis (LNM) based on tumor site has not been confirmed yet. Methods: Patients who underwent curative-intent surgery at 10 tertiary referral centers were identified and divided into peripheral (PP) and near second confluence level tumor (NC) groups on the basis of the distance from the second confluence and ontological outcomes were compared. Results: Of 179 patients, 121 patients with LND were divided into the NC (n = 89) and PP groups (n = 32) on the basis of 4.5 cm from the second confluence. NC group showed higher LNM rate than PP group (46.1 vs 21.9%, p = 0.016) and NC was a risk factor for LNM (odds ratio: 4.367; 95% confidence interval: 1.234-15.453, p = 0.022). The 5-year overall survival (OS) rate (38.0% vs. 27.8%, p = 0.777) and recurrence-free survival (RFS) rates (22.8% vs. 25.8%, p = 0.742) showed no differences between the PP and NC groups. In the NC group, N1 patients showed worse 5-year OS (12.7% vs 39.0%, p = 0.004) and RFS (8.8% vs 28.6%, p = 0.004) than the NO patients. In the PP group, discordant results in 5-year OS (48.9% vs. 50.0%, p = 0.462) and RFS (41.3% vs. 0%, p = 0.056) were found between the NO and N1 patients. Conclusion: The NC group was an independent risk factor for LNM and LNM worsened prognosis in NC group for ICCA. In the PP group, LND should not be omitted because of high LNM rate and insufficient oncologic evidence. (C) 2019 The Authors. Published by Elsevier Ltd.
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