scholarly journals Should Lymph Nodes Be Retrieved in Patients with Intrahepatic Cholangiocarcinoma? A Collaborative Korea–Japan Study

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 445
Author(s):  
Chang Moo Kang ◽  
Kyung-Suk Suh ◽  
Nam-Joon Yi ◽  
Tae Ho Hong ◽  
Sang Jae Park ◽  
...  
Keyword(s):  
Lymph Node ◽  
Intrahepatic Cholangiocarcinoma ◽  
Goodness Of Fit ◽  
Tumor Location ◽  
Surgical Strategy ◽  
Oncologic Outcomes ◽  
Goodness Of Fit Test ◽  
Metastatic Node

Background: This study was performed to investigate the oncologic role of lymph node (LN) management and to propose a surgical strategy for treating intrahepatic cholangiocarcinoma (IHCC). Methods: The medical records of patients with resected IHCC were retrospectively reviewed from multiple institutions in Korea and Japan. Short-term and long-term oncologic outcomes were analyzed according to lymph node metastasis (LNM). A nomogram to predict LNM in treating IHCC was established to propose a surgical strategy for managing IHCC. Results: A total of 1138 patients were enrolled. Of these, 413 patients underwent LN management and 725 did not. A total of 293 patients were found to have LNM. The No. 12 lymph node (36%) was the most frequent metastatic node, and the No. 8 lymph node (21%) was the second most common. LNM showed adverse long-term oncologic impact in patients with resected IHCC (14 months, 95% CI (11.4–16.6) vs. 74 months, 95% CI (57.2–90.8), p < 0.001), and the number of LNM (0, 1–3, 4≤) was also significantly related to negative oncologic impacts in patients with resected IHCC (74 months, 95% CI (57.2–90.8) vs. 19 months, 95% CI (14.4–23.6) vs. 11 months, 95% CI (8.1–13.8)), p < 0.001). Surgical retrieval of more than four (≥4) LNs could improve the survival outcome in resected IHCC with LNM (13 months, 95% CI (10.4–15.6)) vs. 30 months, 95% CI (13.1–46.9), p = 0.045). Based on preoperatively detectable parameters, a nomogram was established to predict LNM according to the tumor location. The AUC was 0.748 (95% CI: 0.706–0.788), and the Hosmer and Lemeshow goodness of fit test showed p = 0.4904. Conclusion: Case-specific surgical retrieval of more than four LNs is required in patients highly suspected to have LNM, based on a preoperative detectable parameter-based nomogram. Further prospective research is needed to validate the present surgical strategy in resected IHCC.

A long-term survivor of intrahepatic cholangiocarcinoma with paraaortic lymph node metastasis

2006 ◽  
Vol 41 (4) ◽  
pp. 391-392 ◽  
Author(s):  
Takahiro Uenishi ◽  
Osamu Yamazaki ◽  
Katsuhiko Horii ◽  
Takatsugu Yamamoto ◽  
Shoji Kubo
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Intrahepatic Cholangiocarcinoma ◽  
Paraaortic Lymph Node ◽  
Node Metastasis ◽  
Paraaortic Lymph Node Metastasis ◽  
Term Survivor

scholarly journals The prognostic role of lymphovascular invasion and lymph node metastasis in perihilar and intrahepatic cholangiocarcinoma

HPB ◽  
2020 ◽  
Vol 22 ◽  
pp. S264-S265
Author(s):  
J. Bednarsch ◽  
Z. Czigany ◽  
I. Amygdalos ◽  
D Morales Santana ◽  
M. Den Dulk ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Intrahepatic Cholangiocarcinoma ◽  
Lymphovascular Invasion ◽  
Prognostic Role ◽  
Node Metastasis

847 - Role of Lymph-Node Dissection in Small (≤3CM) Intrahepatic Cholangiocarcinoma

2018 ◽  
Vol 154 (6) ◽  
pp. S-1285
Author(s):  
Andrea Ruzzenente ◽  
Luca Viganò ◽  
Giorgio Ercolani ◽  
Simone Conci ◽  
Andrea Ciangherotti ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Intrahepatic Cholangiocarcinoma ◽  
Node Dissection

scholarly journals The role of lymph node dissection in intrahepatic cholangiocarcinoma: a multicenter retrospective study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hanjie Hu ◽  
Gang Xu ◽  
Shunda Du ◽  
Zhiwen Luo ◽  
Hong Zhao ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Dissection ◽  
Intrahepatic Cholangiocarcinoma ◽  
Proportional Hazards ◽  
Disease Free Survival ◽  
Cox Proportional Hazards ◽  
Node Dissection ◽  
Nccn Guidelines

Abstract Background Lymph node dissection (LND) is of great significance in intrahepatic cholangiocarcinoma (ICC). Although the National Comprehensive Cancer Network (NCCN) guidelines recommend routine LND in ICC, the effects of LND remains controversial. This study aimed to explore the role of LND and some related issues and of in ICC. Methods Patients were identified in two Chinese academic centers. Inverse probability of treatment weighting (IPTW) was used to reduce bias. Kaplan–Meier curves and Cox proportional hazards models were used to compare overall survival (OS) and disease-free survival (DFS). Results Of 232 patients, 177 (76.3%) underwent LND, and 71 (40.1%) had metastatic lymph nodes. A minimum of 6 lymph nodes were dissected in 66 patients (37.3%). LND did not improve the prognosis of ICC. LNM > 3 may have worse OS and DFS than LNM 1–3, especially in the LND >  = 6 group. For patients who did not underwent LND, the adjuvant treatment group had better OS and DFS. Conclusions The proportions of patients who underwent LND and removed >  = 6 lymph nodes were not high enough. LND has no definite predictive effect on prognosis. Patients with 4 or more LNMs may have a worse prognosis than patients with 1–3 LNMs. Adjuvant therapy may benefit patients of nLND.

scholarly journals A phase I pilot study of preoperative radiotherapy for prostate cancer: Long-term toxicity and oncologic outcomes.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 60-60
Author(s):  
Noelia Sanmamed ◽  
Rachel Glicksman ◽  
John Thoms ◽  
Alexandre Zlotta ◽  
Antonio Finelli ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Pilot Study ◽  
High Risk ◽  
Phase I ◽  
Oncologic Outcomes ◽  
Gu Toxicity ◽  
Long Term Follow Up

60 Background: Pre-operative radiotherapy (PreORT) improves local control in various cancer types, and has become an established oncologic treatment strategy. During 2001-2004, we conducted a phase I pilot study assessing the role of short-course PreORT for men with unfavourable intermediate- and high-risk localized prostate cancer (PCa). We present long-term follow-up toxicity and oncologic outcomes. Methods: Eligible patients had histologically proven PCa, cT1-T2N0M0, PSA > 15-35 ng/ml with any Gleason score, or PSA 10-15 ng/ml with Gleason score ≥7. Patients received 25 Gy in five consecutive daily fractions to the prostate, followed by radical prostatectomy (RadP) within 14 days after RT completion. Primary outcomes were intra-operative morbidity, and late genitourinary (GU) and gastrointestinal (GI) toxicities. Acute toxicity was assessed during radiotherapy treatment on daily basis using RTOG grade scoring scale. Patients were assessed post-RadP clinically and with PSA at 1 and 6 months, and every 6 months. Intra- and Post-RadP toxicity was documented prospectively and scored as per Common Terminology Criteria for Adverse Events v4.0. Biochemical failure (BF) was determined based on two consecutive post-RadP PSA > 0.2 ng/ml. Results: Fifteen patients were enrolled; 14 patients completed PreORT followed by RadP, which also included bilateral lymph node dissections in 13 cases. Median follow-up was 12.2 years (range 6.7-16.3 years). Late GU toxicity was common, with 2 patients (14.3%) experiencing G2 toxicity, and 6 patients (42.8%) G3 toxicity. There were no G4-5 late GU toxicity. Late GI toxicity was infrequent, with only 1 patient (7.1%) experiencing transient G2 proctitis. At last follow-up, 8 (57.1%) and 6 (42.8%) patients experienced BF and metastatic disease recurrence, respectively. Conclusions: The use of PreORT in men with high-risk PCa is associated with unexpected high-rates of late GU toxicity. Future studies examining the role of RT pre-RadP must cautiously select RT technique and dose schedule. Importantly, long-term follow-up data is essential to fully determine the therapeutic index of PreORT in the management of localized PCa. Clinical trial information: NCT00252447.

scholarly journals Oncologic outcomes after resection of para-aortic lymph node metastasis in left-sided colon and rectal cancer

2020 ◽  
Author(s):  
Junichi Sakamoto ◽  
Heita Ozawa ◽  
Hiroki Nakanishi ◽  
Shin Fujita
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Management Strategy ◽  
Clinicopathological Characteristics ◽  
Oncologic Outcomes ◽  
Free Survival ◽  
Colon And Rectal Cancer ◽  
Aortic Lymph Node ◽  
Synchronous Resection

Abstract Background The optimal surgical management strategy for para-aortic lymph node (PALN) metastasis has not attracted as much attention as surgery for liver or lung metastasis. The purpose of this retrospective study was to evaluate the oncologic outcomes after synchronous resection of PALN metastasis in left-sided colon and rectal cancer.Methods Between January 1986 and August 2016, 29 patients with pathologically positive PALN metastasis who underwent curative resection at our hospital were retrospectively reviewed. We examined clinicopathological characteristics, long-term oncologic outcomes, and factors related to favorable prognosis in patients with PALN metastasis.Results The 3-year overall survival and recurrence-free survival (RFS) rates were 50.5% and 17.2%, respectively. Six (20.7%) patients experienced no recurrence in the three years after surgery. Postoperative complications were seen in nine (31.0%) patients. The three-year RFS rate was significantly better in the pM1a group than in the pM1b/pM1c group (26.3% and 0.0%, respectively, p = 0.032).Conclusions PALN dissection for left-sided colon or rectal cancer with synchronous PALN metastasis can be a feasible treatment option in selected patients.

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