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Yamamoto Y, Türkoğlu MA, Aramaki T, et al. Vascularity of Intrahepatic Cholangiocarcinoma on Computed Tomography is Predictive of Lymph Node Metastasis. Ann Surg Oncol. 2016;23:485-493doi: 10.1245/s10434-016-5382-1.
Yamamoto, Y., Türkoğlu, M. A., Aramaki, T., Sugiura, T., Okamura, Y., Ito, T., Ashida, R., Uemura, S., Miyata, T., Kato, Y., Kakuta, Y., Nakanuma, Y., & Uesaka, K. (2016). Vascularity of Intrahepatic Cholangiocarcinoma on Computed Tomography is Predictive of Lymph Node Metastasis. Annals of surgical oncology, 23485-493. https://doi.org/10.1245/s10434-016-5382-1
Yamamoto, Yusuke, et al. "Vascularity of Intrahepatic Cholangiocarcinoma on Computed Tomography is Predictive of Lymph Node Metastasis." Annals of surgical oncology vol. 23 (2016): 485-493. doi: https://doi.org/10.1245/s10434-016-5382-1
Yamamoto Y, Türkoğlu MA, Aramaki T, Sugiura T, Okamura Y, Ito T, Ashida R, Uemura S, Miyata T, Kato Y, Kakuta Y, Nakanuma Y, Uesaka K. Vascularity of Intrahepatic Cholangiocarcinoma on Computed Tomography is Predictive of Lymph Node Metastasis. Ann Surg Oncol. 2016 Aug;23:485-493. doi: 10.1245/s10434-016-5382-1. Epub 2016 Jul 08. PMID: 27393571.
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Ann Surg Oncol. 2016 Aug;23:485-493. doi: 10.1245/s10434-016-5382-1. Epub 2016 Jul 08.

Vascularity of Intrahepatic Cholangiocarcinoma on Computed Tomography is Predictive of Lymph Node Metastasis.

Annals of surgical oncology

Yusuke Yamamoto, Mehmet Akif Türkoğlu, Takeshi Aramaki, Teiichi Sugiura, Yukiyasu Okamura, Takaaki Ito, Ryo Ashida, Sunao Uemura, Takashi Miyata, Yoshiyasu Kato, Yuko Kakuta, Yasuni Nakanuma, Katsuhiko Uesaka

Affiliations

  1. Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan. [email protected].
  2. Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
  3. Division of Radiology, Shizuoka Cancer Center, Shizuoka, Japan.
  4. Division of Pathology, Shizuoka Cancer Center, Shizuoka, Japan.

PMID: 27393571 DOI: 10.1245/s10434-016-5382-1

Abstract

BACKGROUND: The indications for lymph node dissection (LND) for intrahepatic cholangiocarcinoma (ICC) are controversial.

METHODS: Seventy patients with mass-forming dominant ICC underwent hepatectomy with systematic LND or lymph node sampling between 2003 and 2013. We defined the computed tomography (CT) ratio as the CT value (Hounsfield units) of the tumor divided by the CT value (Hounsfield units) of the liver parenchyma in the late arterial phase, and investigated the indications for LND with hepatectomy for ICC.

RESULTS: A multivariate analysis identified lymph node metastasis (LNM; n = 19, p = 0.012) and perineural invasion (p = 0.017) as independent predictors of survival. The median survival time and 5-year survival rate in patients exhibiting LNM were 31.1 months and 16.0 %, respectively. In a subgroup analysis of patients without LNM, overall survival was comparable between patients treated with LND and those treated without LND (p = 0.801). A multivariate analysis of the preoperatively measurable parameters revealed that a CT ratio <0.88 and macroscopic periductal infiltration were independently associated with LNM. We developed a score predicting LNM of mass-forming dominant ICC (LMIC score), assigning 1 point for each of these risk factors. The percentages of patients with LNM with an LMIC score of 0, 1, or 2 points were 0, 35, and 58 %, respectively.

CONCLUSIONS: The vascularity of ICC is associated with important prognostic factors, LNM, and perineural invasion. LN dissection would be conducted in patients with an LMIC score of one or two points but can be omitted in patients with an LMIC score of zero.

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