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Impact of Lymph Node Dissection for Patients With Clinically Node-Negative Intrahepatic Cholangiocarcinoma: A
Meng Sha1,2, Jie Cao1,2, Cheng Lin Qin3,2
1Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
World Journal of Oncology
|July 12, 2024
Summary
Lymph node dissection (LND) did not improve outcomes for intrahepatic cholangiocarcinoma (ICC) patients with clinically node-negative status. Postoperative adjuvant therapy, however, significantly improved survival, particularly in patients not undergoing LND.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Gastroenterology
Background:
- Lymph node status is critical for intrahepatic cholangiocarcinoma (ICC) prognosis.
- The benefit of lymph node dissection (LND) in clinically node-negative ICC patients is debated.
- This study investigates the clinical value of LND in this specific patient subgroup.
Purpose of the Study:
- To evaluate the impact of lymph node dissection (LND) on long-term outcomes.
- To assess recurrence-free survival (RFS) and overall survival (OS) in clinically node-negative ICC patients undergoing LND versus non-LND.
- To identify prognostic factors in ICC patients.
Main Methods:
- Retrospective analysis of 159 clinically node-negative ICC patients from three centers.
- Propensity score matching (1:1 ratio) based on clinicopathological data.
- Comparison of RFS and OS between LND and non-LND groups post-matching.
Main Results:
- No significant difference in median RFS (12.0 vs. 10.0 months) or OS (22.0 vs. 26.0 months) between LND and non-LND groups.
- LND was not an independent predictor of survival.
- Positive lymph nodes after LND indicated worse outcomes.
- Postoperative adjuvant therapy was an independent risk factor for improved RFS and OS, especially in non-LND patients.
Conclusions:
- Lymph node dissection (LND) does not significantly improve prognosis for clinically node-negative intrahepatic cholangiocarcinoma (ICC) patients.
- Postoperative adjuvant therapy is associated with prolonged survival in ICC patients, particularly those not undergoing LND.
