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Impact of nodal involvement on surgical outcomes of intrahepatic cholangiocarcinoma: a multicenter analysis by the Study Group for Hepatic Surgery of the Japanese Society of Hepato‐Biliary‐Pancreatic Surgery
Author(s) -
Uchiyama Kazuhisa,
Yamamoto Masakazu,
Yamaue Hiroki,
Ariizumi Shunichi,
Aoki Taku,
Kokudo Norihiro,
Ebata Tomoki,
Nagino Masato,
Ohtsuka Masayuki,
Miyazaki Masaru,
Tanaka Eiichi,
Kondo Satoshi,
Uenishi Takahiro,
Kubo Shoji,
Yoshida Hiroshi,
Unno Michiaki,
Imura Satoru,
Shimada Mitsuo,
Ueno Masaki,
Takada Tadahiro
Publication year - 2011
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1007/s00534-010-0349-2
Subject(s) - medicine , intrahepatic cholangiocarcinoma , hepatectomy , hazard ratio , multivariate analysis , lymphadenectomy , hepatoduodenal ligament , gastroenterology , metastasis , lymph node , surgery , oncology , general surgery , cancer , confidence interval , resection
Background/purpose The aim of this study was to clarify the prognostic factors of intrahepatic cholangiocarcinoma (ICC) following hepatectomy and to examine the impact of lymph node metastasis on survival. This study was therefore carried out as a Project Study of the Japanese Society of Hepato‐Biliary‐Pancreatic Surgery. Methods Three hundred and forty‐one patients who underwent hepatectomy for ICC between 1995 and 2004 at the 9 institutions of the Medical University Hospitals were analyzed retrospectively. Multivariate regression analyses and a Kaplan–Meyer analysis were performed to identify prognostic factors. Results Pathological lymph node metastasis was one of the significant factors affecting overall survival (hazard ratio 2.10, p < 0.001) based on the multivariate analysis. Among the patients who underwent extended lymphadenectomy beyond the hepatoduodenal ligament, the median survival of 121 patients with nodal involvement was 12.2 months. Only seven patients with nodal involvement have survived for more than 4 years. Conclusions In the present study, preoperative carbohydrate antigen (CA) 19‐9, intrahepatic metastasis, and nodal involvement were the significant independent predictors of poor prognosis by multivariate analysis. Further prospective studies may thus be needed to confirm these findings, because this study has a limitation in that it was a retrospective study with multicenter data collection.