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Lymph Node Examination and Patterns of Nodal Metastasis Among Patients with Left- Versus Right-Sided Intrahepatic Cholangiocarcinoma After Major Curative-Intent Resection

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Bibliographic Details
Title: Lymph Node Examination and Patterns of Nodal Metastasis Among Patients with Left- Versus Right-Sided Intrahepatic Cholangiocarcinoma After Major Curative-Intent Resection
Authors: Zhang X. F., Xue F., Weiss M., Popescu I., Marques H. P., Aldrighetti L., Maithel S. K., Pulitano C., Bauer T. W., Shen F., Poultsides G. A., Cauchy F., Martel G., Koerkamp B. G., Itaru E., Lv Y., Pawlik T. M.
Source: Annals of Surgical Oncology. 30:1424-1433
Publisher Information: Springer Science and Business Media LLC, 2022.
Publication Year: 2022
Subject Terms: Bile Duct Neoplasms* / pathology, Lymph Nodes / pathology, HCC CIR, Prognosis, 3. Good health, Cholangiocarcinoma, 03 medical and health sciences, Bile Ducts, Intrahepatic, 0302 clinical medicine, Bile Duct Neoplasms, Lymphatic Metastasis, Cholangiocarcinoma* / pathology, Lymphatic Metastasis / pathology, Humans, Lymph Node Excision, Hepatectomy, Lymph Nodes / surgery, Lymph Nodes, Bile Ducts, Intrahepatic / pathology
Description: We sought to investigate whether the unique lateral patterns of lymphatic drainage impacted lymphadenectomy (LND), lymph node metastasis (LNM), and long-term survival of patients after curative hemi-hepatectomy for left- versus right-sided intrahepatic cholangiocarcinoma (ICC).Data on patients who underwent curative hemi-hepatectomy for left- or right-sided ICC were collected from 15 high-volume centers worldwide, as well as from the Surveillance, Epidemiology, and End Results (SEER) registry. Primary outcomes included overall survival (OS) and disease-free survival (DFS).Among 697 patients identified from the multi-institutional database, patients who underwent hemi-hepatectomy for left-sided ICC (n = 363, 52.1%) were more likely to have an increased number of LND versus patients with right-sided ICC (n = 334, 47.9%) (median, left 5 versus right 3, p = 0.012), although the frequency (left 66.4% versus right 63.8%, p = 0.469) and station (beyond station no. 12, left 25.3% versus right 21.1%, p = 0.293) were similar. Consequently, left-sided ICC was associated with higher incidence of LNM (left 33.3% versus right 25.7%, p = 0.036), whereas the station and number of LNM were not different (both p > 0.1). There was no difference in OS (median, left 34.9 versus right 29.6 months, p = 0.130) or DFS (median, left 14.5 versus right 15.2 months, p = 0.771) among patients who underwent hemi-hepatectomy for left- versus right-sided ICC, which were also verified in the SEER dataset. LNM beyond station no. 12 was associated with even worse long-term survival versus LNM within station no. 12 among patients with either left- or right-sided ICC after curative-intent resection (all p < 0.05).The unique lateral patterns of lymphatic drainage were closely related to utilization of LND, as well as LNM of left- versus right-sided ICC.
Document Type: Article
File Description: application/pdf
Language: English
ISSN: 1534-4681
1068-9265
DOI: 10.1245/s10434-022-12797-2
Access URL: https://pubmed.ncbi.nlm.nih.gov/36400889
https://hdl.handle.net/20.500.11768/163784
https://link.springer.com/article/10.1245/s10434-022-12797-2
https://doi.org/10.1245/s10434-022-12797-2
http://hdl.handle.net/10400.17/5000
Rights: Springer Nature TDM
Accession Number: edsair.doi.dedup.....d2b41a4dd090eb8bdd130a640ae0c9e3
Database: OpenAIRE
Description
Abstract:We sought to investigate whether the unique lateral patterns of lymphatic drainage impacted lymphadenectomy (LND), lymph node metastasis (LNM), and long-term survival of patients after curative hemi-hepatectomy for left- versus right-sided intrahepatic cholangiocarcinoma (ICC).Data on patients who underwent curative hemi-hepatectomy for left- or right-sided ICC were collected from 15 high-volume centers worldwide, as well as from the Surveillance, Epidemiology, and End Results (SEER) registry. Primary outcomes included overall survival (OS) and disease-free survival (DFS).Among 697 patients identified from the multi-institutional database, patients who underwent hemi-hepatectomy for left-sided ICC (n = 363, 52.1%) were more likely to have an increased number of LND versus patients with right-sided ICC (n = 334, 47.9%) (median, left 5 versus right 3, p = 0.012), although the frequency (left 66.4% versus right 63.8%, p = 0.469) and station (beyond station no. 12, left 25.3% versus right 21.1%, p = 0.293) were similar. Consequently, left-sided ICC was associated with higher incidence of LNM (left 33.3% versus right 25.7%, p = 0.036), whereas the station and number of LNM were not different (both p > 0.1). There was no difference in OS (median, left 34.9 versus right 29.6 months, p = 0.130) or DFS (median, left 14.5 versus right 15.2 months, p = 0.771) among patients who underwent hemi-hepatectomy for left- versus right-sided ICC, which were also verified in the SEER dataset. LNM beyond station no. 12 was associated with even worse long-term survival versus LNM within station no. 12 among patients with either left- or right-sided ICC after curative-intent resection (all p < 0.05).The unique lateral patterns of lymphatic drainage were closely related to utilization of LND, as well as LNM of left- versus right-sided ICC.
ISSN:15344681
10689265
DOI:10.1245/s10434-022-12797-2