Comparative analysis of lymph node metastasis and dissection in patients with intrahepatic cholangiocarcinoma at various anatomical locations and their impact on prognosis
10.3760/cma.j.cn113884-20240407-00098
- VernacularTitle:不同解剖位置肝内胆管癌患者淋巴结转移与清扫的比较及对预后的影响
- Author:
Weixuan XIE
1
;
Yang BAI
;
Qingzhou ZHU
;
Kunlun LUO
Author Information
1. 中国人民解放军联勤保障部队第九〇四医院肝胆外科，无锡 214044
- Keywords:
Cholangiocarcinoma;
Prognosis;
Lymphadenectomy;
Anatomical location
- From:
Chinese Journal of Hepatobiliary Surgery
2024;30(7):499-504
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study and compare the impact of lymph node metastasis and dissection on the prognosis of intrahepatic cholangiocarcinoma (ICC) patients at different anatomical locations, as well as the effect on prognosis.Methods:A retrospective analysis was conducted on the clinical data of 150 ICC patients who underwent radical surgical resection at the 904th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from September 2017 to September 2020. Among them, 86 were males and 64 were females, with the age of (56.2±12.9) years. Differences in albumin-bilirubin (ALBI) grade, preoperative lymph node metastasis risk, number of lymph nodes dissected, lymph node metastasis, and postoperative survival between peripheral and central ICC patients were compared to analyze the impact of lymph node dissection on the prognosis of ICC patients at different locations.Results:There were statistically significant differences in ALBI grade, preoperative lymph node metastasis risk, the number of lymph nodes dissected, and lymph node metastasis between 98 cases of peripheral ICC and 52 cases of central ICC (all P<0.05). The 3-year overall survival rates for peripheral and central ICC patients were 30.6% and 15.4%, respectively, with a statistically significant difference ( χ2=8.46, P=0.004). Among central ICC patients, the 3-year overall survival rates for those with ≥6 lymph nodes dissected and <6 lymph nodes dissected were 16.7% and 12.5%, respectively, with a statistically significant difference ( χ2=3.96, P=0.046). In the high-risk central ICC patients with preoperative lymph node metastasis, the 3-year overall survival rate of ≥6 lymph nodes dissection ( n=22) and <6 lymph nodes dissection ( n=12) were 13.6% and 8.3%, respectively, with statistical significance ( χ2=5.55, P=0.019). Conclusions:The prognosis of peripheral ICC patients is better than that of central ICC patients. For central ICC patients with a high preoperative lymph node metastasis risk, adequate lymph node dissection can lead to a better prognosis.
