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Prognostic value of retrieved lymph node counts in patients with node‐negative perihilar cholangiocarcinomas
Author(s) -
Lin Huapeng,
Wu YuShen,
Li Zhongyi,
Jiang Yicheng
Publication year - 2018
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.14775
Subject(s) - medicine , lymph node , proportional hazards model , stage (stratigraphy) , survival analysis , multivariate analysis , univariate analysis , oncology , radiology , paleontology , biology
Background This study aimed to find out the prognostic value and optimal cut‐off value of retrieved lymph node (LN) counts in patients with node‐negative perihilar cholangiocarcinomas. Methods The Surveillance, Epidemiology and End Results (SEER) database was used to screen out patients with perihilar cholangiocarcinoma. The cut‐off number of retrieved LNs was determined by the X‐tile programme. Kaplan–Meier methods with log‐rank tests and Cox regression analysis were used for survival analysis. Results A total of 778 patients with perihilar cholangiocarcinoma (2004–2014) met the inclusion criteria for this research, and there were 403 patients without LN metastases (N0) among them. The cut‐off numbers of retrieved LNs, which were determined using the X‐tile programme, were 8 and 18. Both results of univariate and multivariate survival analyses in N0 patients showed that patients with ≥18 retrieved LNs had a significantly better survival rate than patients with 1–7 retrieved LNs and patients with 8–17 retrieved LNs. In the subgroup of patients with early‐stage tumours, patients with at least 13 retrieved LNs had a significantly better overall and cancer‐specific survival than patients with fewer retrieved LNs. Conclusions The retrieved LN counts are an independent prognostic factor for patients with node‐negative perihilar cholangiocarcinoma. Patients with at least 18 retrieved LNs had a better overall and cancer‐specific survival than patients with fewer retrieved LNs. The minimum requirement for retrieving of LNs should reach 18 in perihilar cholangiocarcinoma.