TY - JOUR
T1 - Lymphadenectomy in the staging and treatment of intrahepatic cholangiocarcinoma
T2 - A population-based study using the National Cancer Institute SEER database
AU - Clark, Clancy J.
AU - Wood-Wentz, Christina M.
AU - Reid-Lombardo, Kaye M.
AU - Kendrick, Michael L.
AU - Huebner, Marianne
AU - Que, Florencia G.
N1 - Funding Information:
Funding for this study was provided by the Mayo Clinic, Rochester, MN, USA. KMR-L was funded by the National Center for Research Resources (NCRR; http://www.ncrr.nih.gov ) (grant no. 1 UL1 RR024150), a component of the National Institutes of Health (NIH) and the NIH Roadmap for Medical Research ( http://nihroadmap.nih.gov ). The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official views of the NCRR or NIH.
PY - 2011/9
Y1 - 2011/9
N2 - Objectives: Although lymphatic spread is common in intrahepatic cholangiocarcinoma (ICC), lymphadenectomy is not widely performed as part of operative resection in this disease. The objectives of this study were to assess national trends for lymphadenectomy and its impact on survival in patients with ICC. Methods: The National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) registry was queried to identify patients with ICC (n= 4893) reported during 1988-2007. Kaplan-Maier and Cox proportional hazards regression were used to analyse survival. Results: Five-year overall survival (OS) was 5.2%. Lymph node (LN) status was available for 48.9% (n= 2391) of patients. Histologic LN evaluation was performed in 13.5% (n= 658) of patients for a median of two (interquartile range: 1-3) LNs. During the study period, the frequency of histologic LN assessment (P= 0.78) did not change in liver resection patients. In the 733 resected patients, positive vs. negative LN status was associated with worse 5-year OS of 8.4% vs. 25.9%, respectively (hazard ratio = 1.8; P < 0.001). Conclusions: Nodal status is an important prognostic factor for survival in patients diagnosed with ICC. In the USA, few patients undergo hepatic resection with lymphadenectomy; therefore, the clinical benefit of formal lymphadenectomy in ICC remains unknown.
AB - Objectives: Although lymphatic spread is common in intrahepatic cholangiocarcinoma (ICC), lymphadenectomy is not widely performed as part of operative resection in this disease. The objectives of this study were to assess national trends for lymphadenectomy and its impact on survival in patients with ICC. Methods: The National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) registry was queried to identify patients with ICC (n= 4893) reported during 1988-2007. Kaplan-Maier and Cox proportional hazards regression were used to analyse survival. Results: Five-year overall survival (OS) was 5.2%. Lymph node (LN) status was available for 48.9% (n= 2391) of patients. Histologic LN evaluation was performed in 13.5% (n= 658) of patients for a median of two (interquartile range: 1-3) LNs. During the study period, the frequency of histologic LN assessment (P= 0.78) did not change in liver resection patients. In the 733 resected patients, positive vs. negative LN status was associated with worse 5-year OS of 8.4% vs. 25.9%, respectively (hazard ratio = 1.8; P < 0.001). Conclusions: Nodal status is an important prognostic factor for survival in patients diagnosed with ICC. In the USA, few patients undergo hepatic resection with lymphadenectomy; therefore, the clinical benefit of formal lymphadenectomy in ICC remains unknown.
KW - cholangiocarcinoma
KW - outcomes < cholangiocarcinoma
KW - resection < cholangiocarcinoma
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U2 - 10.1111/j.1477-2574.2011.00340.x
DO - 10.1111/j.1477-2574.2011.00340.x
M3 - Article
C2 - 21843261
AN - SCOPUS:80051875767
SN - 1365-182X
VL - 13
SP - 612
EP - 620
JO - HPB
JF - HPB
IS - 9
ER -