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Oncologic Impact of Lymph Node Dissection for Intrahepatic Cholangiocarcinoma: a PropensityScore-Matched Study

 Sung Hyun Kim  ;  Dai Hoon Han  ;  Gi Hong Choi  ;  Jin Sub Choi  ;  Kyung Sik Kim 
 Journal of Gastrointestinal Surgery, Vol.23(3) : 538-544, 2019 
Journal Title
 Journal of Gastrointestinal Surgery 
Issue Date
Hepatectomy ;  Intrahepatic cholangiocarcinoma ;  Lymph node excision ;  Propensity score ; Treatment outcomes
BACKGROUND: Intrahepatic cholangiocarcinoma is a malignancy of the intrahepatic biliary tree. Although surgical resection is the mainstay of treatment for this tumor, the impact of lymph node dissection during hepatectomy is controversial. In this study, we evaluated the impact of lymph node dissection during surgical resection for intrahepatic cholangiocarcinoma. METHODS: Records from 170 patients who underwent radical hepatectomy for intrahepatic cholangiocarcinoma from January 2000 to December 2014 were retrospectively reviewed. Twenty-two patients who underwent R1 resection or had distant metastasis at the time of surgery were excluded. Using propensity score matching (matched factors: differentiation, lymphovascular invasion, perineural invasion, and T stage), the patients were divided into two groups: no dissection (n = 34) or lymph node dissection (n = 34). Disease-free survival and overall survival were compared between groups. RESULTS: There was a marginally significant difference between the two groups with respect to the disease-free survival (no dissection vs. lymph node dissection: 20.0 [4.2-35.8] months vs. 64.0 [27.3-120.8] months, p = 0.077). Overall survival was significantly longer in the lymph node dissection group (no dissection vs. lymph node dissection: 44.0 [31.1-56.9] months vs. 90.0 [51.1-158.9] months, p = 0.027). CONCLUSION: Radical surgery including an adequate lymph node dissection area and suitable harvested lymph nodes appears to improve oncologic outcomes for intrahepatic cholangiocarcinoma.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Kim, Sung Hyun(김성현)
Choi, Gi Hong(최기홍) ORCID logo https://orcid.org/0000-0002-1593-3773
Choi, Jin Sub(최진섭)
Han, Dai Hoon(한대훈) ORCID logo https://orcid.org/0000-0003-2787-7876
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