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Trends in Use of Lymphadenectomy in Surgery with Curative Intent for Intrahepatic Cholangiocarcinoma

2018Journal article Open access
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dc.contributor.authorZhang, XF
dc.contributor.authorChakedis, J
dc.contributor.authorBagante, F
dc.contributor.authorChen, Q
dc.contributor.authorBeal, EW
dc.contributor.authorLv, Y
dc.contributor.authorWeiss, M
dc.contributor.authorPopescu, I
dc.contributor.authorPinto Marques, H
dc.contributor.authorAldrighetti, L
dc.contributor.authorMaithel, SK
dc.contributor.authorPulitano, C
dc.contributor.authorBauer, TW
dc.contributor.authorShen, F
dc.contributor.authorPoultsides, GA
dc.contributor.authorSoubrane, O
dc.contributor.authorMartel, G
dc.contributor.authorGroot Koerkamp, B
dc.contributor.authorGuglielmi, A
dc.contributor.authorItaru, E
dc.contributor.authorPawlik, TM
dc.date.accessioned2023-02-20T16:25:38Z
dc.date.available2023-02-20T16:25:38Z
dc.date.issued2018
dc.description.abstractBackground: The role of routine lymph node dissection (LND) in the surgical treatment of intrahepatic cholangiocarcinoma (ICC) remains controversial. The objective of this study was to investigate the trends of LND use in the surgical treatment of ICC. Methods: Patients undergoing curative intent resection for ICC in 2000-2015 were identified from an international multi-institutional database. Use of lymphadenectomy was evaluated over time and by geographical region (West versus East); LND use and final nodal status were analysed relative to AJCC T categories. Results: Among the 1084 patients identified, half (535, 49·4 per cent) underwent concomitant hepatic resection and LND. Between 2000 and 2015, the proportion of patients undergoing LND for ICC nearly doubled: 44·4 per cent in 2000 versus 81·5 per cent in 2015 (P < 0·001). Use of LND increased over time among both Eastern and Western centres. The odds of LND was associated with the time period of surgery and the extent of the tumour/T status (referent T1a: OR 2·43 for T2, P = 0·001; OR 2·13 for T3, P = 0·016). Among the 535 patients who had LND, lymph node metastasis (LNM) was noted in 209 (39·1 per cent). Specifically, the incidence of LNM was 24 per cent in T1a disease, 22 per cent in T1b, 42·9 per cent in T2, 48 per cent in T3 and 66 per cent in T4 (P < 0·001). AJCC T3 and T4 categories, harvesting of six or more lymph nodes, and presence of satellite lesions were independently associated with LNM. Conclusion: The rate of LNM was high across all T categories, with one in five patients with T1 disease having nodal metastasis. The trend in increased use of LND suggests a growing adoption of AJCC recommendations in the treatment of ICC.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationBr J Surg . 2018 Jun;105(7):857-866.pt_PT
dc.identifier.doi10.1002/bjs.10827pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/4418
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.subjectHCC CIRpt_PT
dc.subjectAgedpt_PT
dc.subjectFemalept_PT
dc.subjectMalept_PT
dc.subjectHumanspt_PT
dc.subjectMiddle Agedpt_PT
dc.subjectBile Duct Neoplasms / classificationpt_PT
dc.subjectBile Duct Neoplasms / pathologypt_PT
dc.subjectBile Duct Neoplasms / surgery*pt_PT
dc.subjectCholangiocarcinoma / classificationpt_PT
dc.subjectCholangiocarcinoma / pathologypt_PT
dc.subjectCholangiocarcinoma / surgery*pt_PT
dc.subjectDatabases, Factualpt_PT
dc.subjectHepatectomypt_PT
dc.subjectLymph Node Excision / statistics & numerical data*pt_PT
dc.subjectLymphatic Metastasispt_PT
dc.subjectNeoplasm Stagingpt_PT
dc.titleTrends in Use of Lymphadenectomy in Surgery with Curative Intent for Intrahepatic Cholangiocarcinomapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage866pt_PT
oaire.citation.issue7pt_PT
oaire.citation.startPage857pt_PT
oaire.citation.titleBritish Journal of Surgerypt_PT
oaire.citation.volume105pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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