Prognostic impact of the number of metastatic lymph nodes in distal bile duct cancer: An analysis of Japanese registration cases by the study group for biliary surgery of the Japanese Society of Hepato-Biliary-Pancreatic Surgery.

Journal of Hepato-biliary-pancreatic Sciences
Shin IshiharaMasakazu Yamamoto

Abstract

Lymph node metastasis is an important prognostic factor for distal bile duct cancer. The number of lymph node metastases was adopted for nodal classification. However, different cutoff values have been proposed, ranging from two to five. A total of 1748 cases who underwent curative surgery with pancreatoduodenectomy for distal bile duct cancer registered in the nationwide biliary tract cancer registry in Japan from 2008 to 2013 were included. Univariate Cox regression was performed to assess the effect of prognostic lymph node metastasis counts on mortality and to determine cutoff values. The overall survival rate after resection was 47.4% at 5 years. Univariate and multivariate analysis found prognostic factors to include lymph node metastasis. The cutoff point was set to two lymph node metastases using the Cox model. There were significant differences in pairwise comparisons between three groups by the number of metastatic lymph node (P < .001 for 0 vs 1-2 and P = .003 for 1-2 vs ≥3). Our data suggest lymph node classification as N0 (patients without lymph node metastases), N1 (metastasis in 1-2 regional lymph nodes), and N2 (metastases in ≥3 regional lymph nodes).

References

Sep 29, 2006·World Journal of Surgery·Yoshiaki MurakamiTaijiro Sueda
Mar 29, 2007·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Roderich E Schwarz, David D Smith
Apr 21, 2007·Digestive Surgery·Shin IshiharaAkihiko Horiguchi
Jan 23, 2015·The British Journal of Surgery·M KiriyamaUNKNOWN Nagoya Surgical Oncology Group
Feb 19, 2015·Journal of Hepato-biliary-pancreatic Sciences·Masaru MiyazakiTadahiro Takada
Aug 5, 2015·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Byoung Hyuck KimSung W Ha

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