Lymph Node Metastasis Around the Common Hepatic Artery Is Associated With Dismal Prognosis in Patients Undergoing Resection of Extrahepatic Cholangiocarcinoma.

IF 2.8 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2025-07-29 DOI:10.1002/jhbp.12194

Sho Kiritani, Yoshikuni Kawaguchi, Yusuke Kazami, Kyoji Ito, Yujiro Nishioka, Yuichiro Mihara, Akihiko Ichida, Takeshi Takamoto, Nobuhisa Akamatsu, Kiyoshi Hasegawa

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引用次数: 0

Abstract

Background: Lymph node (LN) metastasis in extrahepatic cholangiocarcinoma (eCCA) is associated with poor prognosis, but the impact of specific metastatic sites is unclear. This study investigated the clinical significance of LN metastasis around the common hepatic artery (N [CHA]) in eCCA.

Methods: A total of 291 patients who underwent curative resection for eCCA between 2002 and 2022 were retrospectively reviewed. Patients were classified as N1 (CHA), N1 (other, regional LN metastasis without CHA), or N0. Clinical characteristics and long-term outcomes were compared. The short-to-long axis ratio (SLR) of CHA nodes on preoperative CT was evaluated for diagnostic value.

Results: Of 291 patients, 164 had perihilar and 127 had distal cholangiocarcinoma. The N1 (CHA), N1 (other), and N0 groups included 33, 103, and 155 patients, respectively. Five-year cancer-specific survival (CSS) rates were 6.9% (N1 [CHA]), 24.7% (N1 [other]), and 60.3% (N0). N1 (CHA) and N1 (other) had CSS hazard ratios of 3.34 and 1.86, respectively (p < 0.01). The area under the receiver operating characteristics curve for SLR in predicting N1 (CHA) was 0.779.

Conclusions: N1 (CHA) is a strong negative prognostic factor in eCCA. CHA node status may serve as a useful imaging-based marker of biological resectability.

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肝外胆管癌切除术患者肝总动脉周围淋巴结转移与预后不良相关

背景：肝外胆管癌（eCCA）的淋巴结（LN）转移与预后不良有关，但具体转移部位的影响尚不清楚。本研究探讨肝总动脉（N [CHA]）周围淋巴结转移在eCCA中的临床意义。方法：回顾性分析2002年至2022年间291例eCCA根治性切除术患者的临床资料。患者分为N1 (CHA), N1（其他，无CHA的区域淋巴结转移）和N0。比较临床特征和远期结果。评估术前CT上CHA淋巴结的长短轴比（SLR）的诊断价值。结果：291例患者中，肝门周围胆管癌164例，远端胆管癌127例。N1 （CHA）组33例，N1（其他）组103例，N0组155例。5年癌症特异性生存率（CSS）分别为6.9% （N1 [CHA]）、24.7% （N1 [other]）和60.3% （N0）。N1 （CHA）和N1 （other）的CSS危险比分别为3.34和1.86 (p)。结论：N1 （CHA）是eCCA患者预后不良的重要因素。CHA节点状态可作为一种有用的基于成像的生物可切除性标记。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY

自引率

10.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.