Affiliation:
1. Department of Hepatobiliary Surgery, National Clinical Research Center for Cancer Hospital, Beijing, China
2. Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Abstract
Background Although the National Comprehensive Cancer Network guidelines recommend routine lymph node dissection (LND) in intrahepatic cholangiocarcinoma (ICC), the role of LND remains controversial, and the node (N) stage is oversimplified. Methods Patients were identified from the Surveillance, Epidemiology, and End Results research data 18 (SEER 18). Propensity score matching (PSM) was used to reduce bias, and Kaplan–Meier curves and Cox proportional hazards models were used to compare overall survival (OS). The best cutoff values were found using X-tile software. Results Of 2037 patients included in SEER 18, 1147 underwent LND (56.3%); 389 (34.3%) had pathologically confirmed lymph node metastasis (LNM), and 316 (27.6%) had at least 6 LNDs. The median OS was worse for LND patients (34 months vs. 40 months, respectively), and this result remained after PSM. Male sex, age ≥60 years, tumor size > 5 cm, and LNM were independent prognostic risk factors for ICC. LNM ≥3 was associated with worse OS. Conclusions Only a few LNDs met the requirements per the guidelines. LND does not improve OS in ICC, and the best approach to LND and a better N staging method should be explored further.
Funder
The National The capital health research and development of special
the State Key Project on Infection Diseases of China
The National Natural Science Foundation of China
Sanming Project of Medicine in Shenzhen
Subject
Biochemistry, medical,Cell Biology,Biochemistry,General Medicine
Cited by
4 articles.
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