Surgical Management of Intrahepatic Cholangiocarcinoma: Defining an Optimal Prognostic Lymph Node Stratification Schema

Yuhree Kim, Gaya Spolverato, Neda Amini, Georgios A. Margonis, Rohan Gupta, Aslam Ejaz, Timothy M. Pawlik

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Metastatic disease to the regional lymph node (LN) is a strong predictor of worse long-term outcome after curative-intent resection of intrahepatic cholangiocarcinoma (ICC). The objectives of this study were to assess the prognostic performance of American Joint Committee on Cancer (AJCC)/International Union Against Cancer, 7th edition, N stage, LN ratio (LNR), and log odds of metastatic LN (LODDS) staging criteria in patients with ICC. Methods: The surveillance, epidemiology, and end results cancer registry was queried to identify 749 patients who underwent surgical resection of ICC during 1988–2011. The Kaplan–Meier method and Cox proportional hazards regression models were used to analyze survival. The relative discriminative abilities of the different LN staging systems were assessed by the Harrell concordance index (c statistic). Results: Of the 749 patients, 477 (63.7 %) had no LN metastasis, while 272 (36.3 %) had LN metastasis. Patients with LN metastasis had an increased risk of death (hazard ratio 2.42, 95 % confidence interval 1.98–2.95; P 

Original languageEnglish (US)
Pages (from-to)2772-2778
Number of pages7
JournalAnnals of Surgical Oncology
Volume22
Issue number8
DOIs
StatePublished - Aug 1 2015

ASJC Scopus subject areas

  • Surgery
  • Oncology

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