Details

Autor(en) / Beteiligte

• Kurahara, Hiroshi
• Mataki, Yuko
• Idichi, Tetsuya
• Kawasaki, Yota
• Mori, Shinichiro
• Sasaki, Ken
• Arigami, Takaaki
• Nakajo, Akihiro
• Fukukura, Yoshihiko
• Higashi, Michiyo
• Ohtsuka, Takao

Titel

Spread of lymph node metastasis and adjuvant therapy for distal cholangiocarcinoma

Ist Teil von

• International journal of clinical oncology, 2022-07, Vol.27 (7), p.1212-1221

Ort / Verlag

Singapore: Springer Nature Singapore

Erscheinungsjahr

2022

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Background Lymphatic metastasis is a major route of metastasis in distal cholangiocarcinoma (DCC). The present study aimed to elucidate the pattern of lymph node (LN) metastasis and the effectiveness of LN dissection and postoperative adjuvant chemotherapy in patients with DCC. Methods Patients who underwent surgical resection with curative intent for DCC were enrolled. The nomenclature of the LN stations was defined according to the Japanese Society of Hepato-Biliary-Pancreatic Surgery guidelines. Effectiveness of LN dissection of each station was calculated using frequency of LN metastasis to the station and 5-year survival rate of patients with LN metastasis to that station. Results Of the 105 patients included in the study, 46 (43.8%) had LN metastasis, and 43 (41.0%) underwent postoperative adjuvant therapy. LN metastasis, serum carbohydrate antigen (CA) 19–9 level > 37 U/mL, and positive bile duct margin were independent risk factors for shorter overall survival (OS). The most common metastatic LN station at surgery was No. 13 (32.7%), followed by No. 12 (19.2%), No. 17 (9.6%), and No. 8 (6.6%). There was no effectiveness of LN dissection of the station No. 8, 14, and 16. Adjuvant chemotherapy was significantly associated with longer OS in patients with LN metastasis but not in those with positive ductal margins or serum CA 19–9 level > 37 U/mL. Conclusions Postoperative adjuvant chemotherapy was associated with a better prognosis in patients with DCC and LN metastasis. However, a more effective therapeutic strategy is required to improve the prognosis of patients with other negative prognostic factors.