Abstract
BackgroundLymph node dissection (LND) is of great significance in intrahepatic cholangiocarcinoma (ICC). Although the National Comprehensive Cancer Network (NCCN) guidelines recommend routine LND in ICC, the effects of LND remains controversial. This study aimed to explore the role of LND and some related issues and of in ICC.MethodsPatients were identified in two Chinese academic centers. Inverse probability of treatment weighting (IPTW) was used to reduce bias. Kaplan–Meier curves and Cox proportional hazards models were used to compare overall survival (OS) and disease-free survival (DFS).ResultsOf 232 patients, 177 (76.3%) underwent LND, and 71 (40.1%) had metastatic lymph nodes. A minimum of 6 lymph nodes were dissected in 66 patients (37.3%). LND did not improve the prognosis of ICC. LNM > 3 may have worse OS and DFS than LNM 1–3, especially in the LND > = 6 group. For patients who did not underwent LND, the adjuvant treatment group had better OS and DFS.ConclusionsThe proportions of patients who underwent LND and removed > = 6 lymph nodes were not high enough. LND has no definite predictive effect on prognosis. Patients with 4 or more LNMs may have a worse prognosis than patients with 1–3 LNMs. Adjuvant therapy may benefit patients of nLND.
Highlights
Bile duct cell carcinoma (BCC) is a highly malignant tumor originating from the bile duct epithelium
Data collection Patients with pathologically confirmed intrahepatic cholangiocarcinoma (ICC), who underwent a radical surgery from April 2003 to December 2018, at the Cancer Hospital and Peking Union Hospital were included in this study
Independent risk factors for ICC Patient characteristics 128 patients from Nation Cancer Center/Cancer Hospital and 104 patients from Peking Union Hospital were included in this study (N = 232). 177 (76.3%) underwent Lymph node dissection (LND), and 71 (40.1%) had at least one lymph node metastasis (LNM)
Summary
Bile duct cell carcinoma (BCC) is a highly malignant tumor originating from the bile duct epithelium. It can be classified as intrahepatic cholangiocarcinoma (ICC), hilar cholangiocarcinoma, and distal cholangiocarcinoma [1]. ICC originates above the secondary branches of the bile duct. ICC comprises about 10% of the primary malignant tumors of the liver, and is the second commonest in this group of tumors [1]. Surgery is the only effective treatment for ICC; only about 20% of the. Lymph node dissection (LND) is of great significance in intrahepatic cholangiocarcinoma (ICC). The National Comprehensive Cancer Network (NCCN) guidelines recommend routine LND in ICC, the effects of LND remains controversial.
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