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Updated: Sep 21, 2025

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[Indications for lymph node dissection in hepatocellular carcinoma].

S E Voskanyan1, E S Chuchuev2, V S Rudakov1

  • 1Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, Moscow, Russia.

Khirurgiia
|June 3, 2022
PubMed
Summary

Lymph node dissection in hepatocellular carcinoma patients did not increase complications. It is recommended for those with high metastasis risk, improving 5-year survival rates.

Keywords:
hepatocellular carcinomaliver resectionlymph node dissectionlymph node metastases

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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.