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The Prognosis and Survival Outcome of Intrahepatic Cholangiocarcinoma Following Surgical Resection: Association of Lymph Node Metastasis and Lymph Node Dissection with Survival

  • Gastrointestinal Oncology
  • Published:
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Abstract

Background

Surgical resection has been shown to improve long-term survival for patients with intrahepatic cholangiocarcinoma (ICC). The benefit of lymph node dissection is still controversial. The aims of this study were to investigate the prognostic factors of ICC and to examine the impact of lymph node metastasis and extent of lymph node dissection on survival.

Materials and Methods

A total of 64 patients with ICC were operated on with curative intent and resultant macroscopic curative resection (R0 and R1). The patients were classified according to the extent of the lymph node dissection. Clinicopathological characteristics and survival were reviewed retrospectively.

Results

All patients underwent anatomical resection. The 5-year survival rates were 39.5%. Multivariate analysis revealed that lymph node metastasis (hazard ratio: 3.317) was an independent prognostic factors on survival. Recurrence occurred in 41 patients. Median disease-free survival time was 12.3 months. Tumor differentiation was an independent prognostic factor for disease-free survival (hazard ratio: 3.158). The extent of lymph node dissection did not affect the occurrence of complication. Regional + α lymph node dissection group demonstrated similar survival to those of lymph node sampling group, although significant high incidence of lymph node metastases was observed in the regional + α lymph node dissection group. The extent of lymph node dissection did not affect the survival in the patients without lymph node involvement.

Conclusions

The regional + α lymph node dissection enhanced the survival in the ICC patients with lymph node metastasis, and the exact nodal status could be confirmed by lymph node dissection in the pericholedochal lymph nodes.

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Authors and Affiliations

  1. Department of Surgery, Korea University College of Medicine, Seoul, Korea

    Sae-Byeol Choi MD

  2. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea

    Kyung-Sik Kim MD, Jin-Sub Choi MD & Woo-Jung Lee MD

  3. Department of Radiology, Yonsei University College of Medicine, Seoul, Korea

    Jin-Young Choi MD

  4. Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea

    Seung-Woo Park MD & Jae-Bock Chung MD

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  1. Sae-Byeol Choi MD
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Correspondence to Kyung-Sik Kim MD.

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Choi, SB., Kim, KS., Choi, JY. et al. The Prognosis and Survival Outcome of Intrahepatic Cholangiocarcinoma Following Surgical Resection: Association of Lymph Node Metastasis and Lymph Node Dissection with Survival. Ann Surg Oncol 16, 3048–3056 (2009). https://doi.org/10.1245/s10434-009-0631-1

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  • DOI: https://doi.org/10.1245/s10434-009-0631-1

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