IDDF2019-ABS-0262 The influence of extent of lymph node dissection on the survival of intrahepatic cholangiocarcinoma with lymph node metastasis. (7th June 2019)

• Record Type: Journal Article
• Authors: Zhang, Ying; Chu, Hongpeng; Chen, Shuling; Peng, Hong; Peng, Sui; Kuang, Ming
• Is Part Of: Gut. Volume 68(2019)Supplement 1
• Page Start: A154
• Page End: A154
• Publication Date: 2019-06-07
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2019-IDDFAbstracts.299
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Background: Surgical resection remains the only curative therapy for intrahepatic cholangiocarcinoma (ICC). Lymph metastasis is one of the major risks for ICC patients with surgery. The benefit of lymph node dissection is controversial. The aim of this study was to investigate the extent of lymph node dissection on the survival of ICC. Methods: From June 1998 to June 2018, a consecutive 78 patients with primary ICC underwent resection with negative surgical margin (R0) and pathological lymph node metastasis (LN+), were enrolled in our study. Patients were divided into the lymph node sampling group (A) and the regional dissection group (B) according to the extent of lymph node dissection. Multivariate COX regression analysis was performed to identify the prognostic factors for the overall survival (OS) and the recurrence-free survival (RFS). OS, RFS, costs and postoperative complications were compared between the two groups. We also investigated number, proportion and groups of LN+ in group B. Results: Median OS was 8.33 months for group A (n=25) and 12.79 months for group B (n=53, P =0.112). The extent of lymph node dissection was not an independent prognostic factor for OS (HR=0.68, 95%CI=0.38–1.19, P =0.177). The corresponding RFS were 3.24 months and 5.95 months for group A and B. RFS of group B was significantly longer than that of group A ( P =0.003). The extent of lymph node dissection (HR=0.47, 95%CI=0.22–0.97, P =0.041) and tumor differentiation (HR=2.01, 95%CI=1.08–4.05, P =0.028) were independent prognostic factors for RFS. In group B, the number of LN+ (>5) significantly influenced RFS (HR=15.01, 95%CI=2.63–85.52, P=0.002). However, postoperative complications (20.0% vs 56.6%, P=0.003) were more frequent in group B than in group A. No significant difference was found in postoperative hospital stay and cost. Conclusions: For LN+ patients, RFS could be significantly prolonged by regional dissection. However, regional dissection did not improve the long-term OS and might lead to higher rates of complications.