Abstract | BACKGROUND: METHODS: Between 1998 and 2010, a total of 47 ICC patients underwent hepatic resection and systematic lymphadenectomy with curative intent. We routinely dissected the PANs and had frozen-section pathological examinations performed intraoperatively. If PAN metastases were identified, curative resection was abandoned. We retrospectively investigated the prognostic factors for patient survival after curative resection for ICC without PAN metastases, with particular attention paid to the prognostic impact of lymphadenectomy. RESULTS: Univariate analysis identified concomitant portal vein resection, concomitant hepatic artery resection, intraoperative blood loss, intraoperative transfusion, and residual tumor as significant negative prognostic factors. However, lymph node status was not identified as a significant prognostic factor. The 14 patients with node-positive cancer had a survival rate of 20 % at 5 years. Based on multivariate analysis, intraoperative transfusion was an independent prognostic factor associated with a poor prognosis (risk ratio = 4.161; P = 0.0056). CONCLUSIONS: Regional lymph node metastasis in ICC should be classified as resectable disease, because the survival rate after surgical intervention was acceptable when PAN metastasis was pathologically negative.
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Authors | Tomohide Nakayama, Takahiro Tsuchikawa, Toshiaki Shichinohe, Toru Nakamura, Yuma Ebihara, Satoshi Hirano |
Journal | World journal of surgery
(World J Surg)
Vol. 38
Issue 7
Pg. 1763-8
(Jul 2014)
ISSN: 1432-2323 [Electronic] United States |
PMID | 24378552
(Publication Type: Journal Article)
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Topics |
- Aged
- Aorta
- Bile Duct Neoplasms
(mortality, secondary, surgery)
- Bile Ducts, Intrahepatic
(surgery)
- Blood Loss, Surgical
- Blood Transfusion
- Cholangiocarcinoma
(mortality, secondary, surgery)
- Female
- Hepatic Artery
(surgery)
- Humans
- Intraoperative Care
- Lymph Node Excision
(mortality)
- Lymph Nodes
(pathology, surgery)
- Lymphatic Metastasis
- Male
- Middle Aged
- Neoplasm, Residual
- Patient Selection
- Portal Vein
(surgery)
- Prognosis
- Retrospective Studies
- Survival Rate
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