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Recommended Minimal Number of Harvested Lymph Nodes for Intrahepatic Cholangiocarcinoma

Authors
 Sung Hyun Kim  ;  Dai Hoon Han  ;  Gi Hong Choi  ;  Jin Sub Choi  ;  Kyung Sik Kim 
Citation
 JOURNAL OF GASTROINTESTINAL SURGERY, Vol.25(5) : 1164-1171, 2021-05 
Journal Title
 JOURNAL OF GASTROINTESTINAL SURGERY 
ISSN
 1091-255X 
Issue Date
2021-05
Keywords
Bayesian method ; Intrahepatic cholangiocarcinoma ; Lymph node excision ; Propensity score ; Treatment outcome
Abstract
Background: Lymph node (LN) metastasis is one factor indicating a poor prognosis after radical surgery for intrahepatic cholangiocarcinoma (ICC). Although several guidelines have recommended that LN dissection be strongly considered at the time of ICC surgery, no clear evidence regarding the appropriate number of harvested LNs has been established. Thus, we aimed to identify the minimum number of harvested LNs required for ICC by using a Bayesian Weibull model. Methods: Data from 142 patients who underwent radical hepatectomy (R0) for ICC from January 2000 to December 2018 were retrospectively reviewed. A Bayesian Weibull model was developed to analyze the effect of number of harvested LNs on survival of patients without (N0; n = 71) and with (N1; n = 71) metastatic nodes. We also compared the percentage of N1 patients (i.e., the N1 rate) in each of the five subgroups categorized according to the number of harvested LNs (1-4, 5-8, 9-12, 13-16, and ≥ 17). Results: In patients with 5 or more harvested LNs, the hazard ratio (HR) for LN metastasis was above the reference line (the HR with 5 harvested LNs, 1.95 (1.09-3.45)). The N1 rate of the 1-4 harvested LNs subgroup was lower than that of the other subgroups (e.g., 1-4 vs. 5-8; 16.1% vs. 39.4%, p = 0.014). Conclusion: Our results suggest that at least 5 LNs should be harvested in patients who undergo radical surgery for ICC to promote accurate staging.
Full Text
https://link.springer.com/article/10.1007/s11605-020-04622-6
DOI
10.1007/s11605-020-04622-6
Appears in Collections:
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) ORCID logo https://orcid.org/0000-0001-7683-9687
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
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182817
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