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Prognostic Significance of Lymph Node Ratio in Intrahepatic and Extrahepatic Cholangiocarcinomas

  • 0Division of Surgical Oncology, Department of Surgery, University of Colorado School of Medicine, Aurora, CO 80045, USA.
Cancers +

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January 25, 2025

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January 25, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

The lymph node ratio (LNR) significantly impacts survival for intrahepatic (ICC) and extrahepatic (ECC) cholangiocarcinoma patients after surgery. Higher LNR indicates worse outcomes, allowing for refined patient stratification beyond simple lymph node positivity.

Area Of Science

  • Oncology
  • Surgical Oncology
  • Cancer Prognostics

Background

  • Lymph Node Ratio (LNR) is an emerging prognostic factor in cancer, potentially improving patient stratification for intrahepatic (ICC) and extrahepatic (ECC) cholangiocarcinoma.
  • Existing prognostic models for ICC and ECC may not fully capture survival nuances, necessitating refined stratification tools.

Purpose Of The Study

  • To evaluate the prognostic impact of the Lymph Node Ratio (LNR) on survival outcomes in patients who underwent surgical resection for ICC and ECC.
  • To determine if LNR provides incremental prognostic value beyond lymph node positivity in cholangiocarcinoma.

Main Methods

  • Retrospective analysis of the National Cancer Database (2004-2020) including patients with ICC and ECC who underwent primary tumor resection and adequate lymphadenectomy (≥4 LNs).
  • LNR calculated as the ratio of positive to total examined lymph nodes.
  • Survival probabilities analyzed using Kaplan-Meier and Cox regression, adjusting for clinical and pathological variables.

Main Results

  • Analysis included 954 ICC and 1607 ECC patients.
  • For ICC, median overall survival (OS) decreased significantly with increasing LNR (62.7 months for LNR 0, 40.8 months for LNR < 30%, 25.2 months for LNR ≥ 30%).
  • Adjusted Cox regression revealed LNR < 30% and LNR ≥ 30% were independently associated with worse OS in both ICC and ECC patients compared to LNR 0.

Conclusions

  • Lymph node status is a critical determinant of survival in ICC and ECC.
  • The study confirms that LNR offers a more granular prognostic stratification for ICC and ECC patients than a binary lymph node-positive/negative classification.
  • LNR is a valuable tool for refining prognostication and potentially guiding treatment decisions in resected cholangiocarcinoma.

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