1.Hepatic lymph node metastases in patients with colorectal liver metastases undergoing hepatic artery infusion pump placement
Aaron J. DINERMAN ; Alyssa V. EADE ; Kyle J. HITSCHERICH ; Cathleen HANNAH ; Nebojsa SKORUPAN ; Lindsay R. FRIEDMAN ; Ashley RAINEY ; Andrew M. BLAKELY ; Baris TURKBEY ; Jonathan M. HERNANDEZ
Annals of Hepato-Biliary-Pancreatic Surgery 2026;30(1):15-23
Background:
s/Aims: The status of portal lymph nodes is a critical factor in determining eligibility for hepatic artery infusion pump (HAIP) therapy. However, methods for detecting occult positive nodes and understanding their clinical implications remain inadequately defined.
Methods:
We conducted a retrospective evaluation of a cohort of patients with metastatic colorectal cancer who underwent HAIP.An independent, blinded radiologist reviewed pre-operative imaging to identify predictors for nodal positivity. We performed Kaplan-Meier survival analyses to explore the relationship between hepatic nodal staging and patient survival.
Results:
The study comprised 33 patients, with a median follow-up of 23.5 months (range 2–56 months). The imaging review did not accurately identify patients with hepatic nodal disease. Patients without hepatic nodal metastases (n = 23) had a significantly longer median overall survival (OS) of 27 months compared to those with hepatic nodal metastases, who had a median OS of 11 months (hazard ratio = 4.8, p ≤ 0.01). Hepatic nodal positivity (hLN+) was associated with primary nodal positivity (pLN+, p = 0.036), and all patients with hLN+ were also pLN+.
Conclusions
Hepatic nodal metastases are a predictor of survival in patients receiving HAIP therapy for colorectal liver metastases.Primary nodal positivity may aid in the selection of HAIP candidates by increasing the suspicion of hepatic nodal positivity.

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