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Assessment of the Lymph Node Status in Patients Undergoing Liver Resection for Intrahepatic Cholangiocarcinoma: the New Eighth Edition AJCC Staging System

2018Journal article Open access
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dc.contributor.authorBagante, F
dc.contributor.authorSpolverato, G
dc.contributor.authorWeiss, M
dc.contributor.authorAlexandrescu, S
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.accessioned2019-03-21T10:17:55Z
dc.date.available2019-03-21T10:17:55Z
dc.date.issued2018
dc.description.abstractINTRODUCTION: The role of routine lymphadenectomy for intrahepatic cholangiocarcinoma (ICC) is still controversial. The AJCC eighth edition recommends a minimum of six harvested lymph nodes (HLNs) for adequate nodal staging. We sought to define outcome and risk of death among patients who were staged with ≥6 HLNs versus <6 HLNs. MATERIALS AND METHODS: Patients undergoing hepatectomy for ICC between 1990 and 2015 at 1 of the 14 major hepatobiliary centers were identified. RESULTS: Among 1154 patients undergoing hepatectomy for ICC, 515 (44.6%) had lymphadenectomy. On final pathology, 200 (17.3%) patients had metastatic lymph node (MLN), while 315 (27.3%) had negative lymph node (NLN). Among NLN patients, HLN was associated with 5-year OS (p = 0.098). While HLN did not impact 5-year OS among MLN patients (p = 0.71), the number of MLN was associated with 5-year OS (p = 0.02). Among the 317 (27.5%) patients staged according the AJCC eighth edition staging system, N1 patients had a 3-fold increased risk of death compared with N0 patients (hazard ratio 3.03; p < 0.001). CONCLUSION: Only one fourth of patients undergoing hepatectomy for ICC had adequate nodal staging according to the AJCC eighth edition. While the six HLN cutoff value impacted prognosis of N0 patients, the number of MLN rather than HLN was associated with long-term survival of N1 patients.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Gastrointest Surg. 2018 Jan;22(1):52-59.pt_PT
dc.identifier.doi10.1007/s11605-017-3426-xpt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3205
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerpt_PT
dc.subjectHCC CIRpt_PT
dc.subjectICCpt_PT
dc.subjectBile Duct Neoplasms/pathologypt_PT
dc.subjectBile Duct Neoplasms/surgerypt_PT
dc.subjectBile Ducts, Intrahepaticpt_PT
dc.subjectCholangiocarcinoma/secondary
dc.subjectCholangiocarcinoma/surgery
dc.subjectHepatectomy
dc.subjectLymph Node Excision
dc.subjectLymph Nodes/pathology
dc.subjectLymph Nodes/surgery
dc.subjectLymphatic Metastasis
dc.subjectPrognosis
dc.subjectSurvival Rate
dc.subjectNeoplasm Staging
dc.subjectProportional Hazards Models
dc.titleAssessment of the Lymph Node Status in Patients Undergoing Liver Resection for Intrahepatic Cholangiocarcinoma: the New Eighth Edition AJCC Staging Systempt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage59pt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPage52pt_PT
oaire.citation.titleJournal of Gastrointestinal Surgerypt_PT
oaire.citation.volume22pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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