[Indications for lymph node dissection in hepatocellular carcinoma]

Area of Science:

• Hepatobiliary surgery
• Surgical oncology
• Gastroenterology

Background:

• Hepatocellular carcinoma (HCC) management involves complex decisions regarding surgical intervention.
• The role and indications for lymph node dissection (LND) in HCC remain a subject of ongoing research.
• Understanding metastasis patterns is crucial for optimizing HCC treatment strategies.

Purpose of the Study:

• To define the indications for lymph node dissection in patients diagnosed with hepatocellular carcinoma.
• To evaluate the impact of LND on postoperative outcomes and survival in HCC patients.

Main Methods:

• Retrospective analysis of 105 hepatocellular carcinoma patients who underwent lymph node dissection (groups 8, 9, 12, 13, 16a2).
• Inclusion of patients with concomitant liver diseases.
• Assessment of immediate and long-term treatment outcomes.

Main Results:

• Lymph node dissection did not significantly impact postoperative complications or mortality.
• Tumor burden and concomitant liver diseases were significant factors influencing lymph node metastasis.
• Metastases were predominantly found in lymph nodes larger than 1 cm, with common sites including the hepatoduodenal ligament and retropancreatic zone.
• Five-year survival for patients with lymph node metastases after resection was 32.4%.

Conclusions:

• Lymph node dissection in HCC patients is safe and does not worsen immediate postoperative results, even with concurrent liver conditions.
• LND is recommended for HCC patients identified as high-risk for metastasis or those with confirmed lymph node metastases.
• This approach offers improved survival outcomes compared to other treatments for patients with lymph node involvement.