Skip to main content
SpringerLink
Log in

Metastatic Liver Disease: Hepatic Lymph Node Involvement

  • Reference work entry
  • First Online:
Tumors and Tumor-Like Lesions of the Hepatobiliary Tract

  • 118 Accesses

Abstract

Metastatic cancers of the liver can undergo further spread via the liver lymph drainage system, reaching lymph nodes close to the liver and the retroperitoneal space. Hepatic lymph is drained to a rather large group of locoregional lymph nodes. A first lymph node station is located very close to the liver, in the transverse fissure, associated with the left hepatic artery. Liver-associated lymph nodes are less common and smaller on the right side. The main lymphatic drainage route for hepatic cancer cells, including cells released from metastases, is along the hepatic artery to hepatic nodes at the hilum, from here to the celiac group; along the falciform ligament to right phrenic nodes and then to mediastinal nodes; through the esophageal hiatus and the caval foramen and transdiaphragmatically to right phrenic and mediastinal nodes; to paracardial upper gastric lymph nodes; and along the phrenic arteries directly to celiac nodes. Overall, the prevalence of hepatic pedicle lymph node metastases in diverse liver malignancies ranges from 10 % to 20 %, but the rate of macroscopically visible hepatic locoregional lymph node metastases is less, around 7 %. Involvement of liver-associated lymph nodes in hepatic metastatic disease has an impact on outcome. For hepatic colorectal carcinoma metastasis, intrahepatic lymphatic vascular dissemination is associated with increased risk of recurrence and poor survival, and involvement of liver-associated nodes confers a poorer result following metastasis resection.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 1,599.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 2,499.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Ambiru S, Miyazaki M, Isono T, Ito H, Nakagawa K, Shimizu H, Kusashio K, Furuya S, Nakajima N (1999) Hepatic resection for colorectal metastases: analysis of prognostic factors. Dis Colon Rectum 42:632–639

    Article  CAS  PubMed  Google Scholar 

  • Atreya I, Schimanski CC, Becker C, Wirtz S, Dornhoff H, Schnürer E, Berger MR, Galle PR, Herr W et al (2007) The T-box transcription factor eomesodermin controls CD8 T cell activity and lymph node metastasis in human colorectal cancer. Gut 56:1572–1578

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • August DA, Sugarbaker PH, Schneider PD (1985) Lymphatic dissemination of hepatic metastases. Implications for the follow-up and treatment of patients with colorectal cancer. Cancer 55:1490–1494

    Article  CAS  PubMed  Google Scholar 

  • Beckurts KT, Hölscher AH, Thorban S et al (1997) Significance of lymph node involvement at the hepatic hilum in the resection of colorectal liver metastases. Br J Surg 84:1081–1084

    Article  CAS  PubMed  Google Scholar 

  • Bhatia A, Kumar Y, Kathpalia AS (2009) Granulomatous inflammation in lymph nodes draining cancer: a coincidence or a significant association! Int J Med Med Sci 1:13–16

    Google Scholar 

  • Cardona K, Mastrodomenico P, D’Amico F, Shia J, Gönen M, Weiser MR, Paty PB et al (2013) Detailed pathologic characteristics of the primary colorectal tumor independently predict outcome after hepatectomy for metastases. Ann Surg Oncol 20:148–154

    Article  PubMed  Google Scholar 

  • Chandrasekaran S, King MR (2014) Microenvironment of tumor-draining lymph nodes: opportunities for liposome-based targeted therapy. Int J Mol Sci 15:20209–20239

    Article  PubMed  PubMed Central  Google Scholar 

  • Contassot E, Preynat-Seauve O, French L, Uard B (2009) Lymph node tumor metastases: more susceptible than primary tumors to CD8+ T-cell immune destruction. Trends Immunol 30:569–573

    Article  CAS  PubMed  Google Scholar 

  • Dahl K, Karlsson M, Marits P, Hoffstedt A, Winqvist O, Thörn M (2008) Metinel node – the first lymph node draining a metastasis – contains tumor-reactive lymphocytes. Ann Surg Oncol 15:1454–1463

    Article  PubMed  PubMed Central  Google Scholar 

  • Deki H, Sato T (1988) An anatomic study of the peripancreatic lymphatics. Surg Radiol Anat 10:121–135

    Article  CAS  PubMed  Google Scholar 

  • Deng L, Zhang H, Luan Y, Zhang J, Xing Q, Dong S, Wu X, Liu M, Wang S (2010) Accumulation of foxp3+ T regulatory cells in draining lymph nodes correlates with disease progression and immune suppression in colorectal cancer patients. Clin Cancer Res 16:4105–4112

    Article  CAS  PubMed  Google Scholar 

  • Elias DM, Ouellet JF (2003) Incidence, distribution, and significance of hilar lymph node metastases in hepatic colorectal metastases. Surg Oncol Clin N Am 12:221–229

    Article  PubMed  Google Scholar 

  • Elias D, Saric J, Jaeck D, Arnaud JP, Gayet B, Rivoire M, Lorimier G, Carles J, Lasser P et al (1996) Prospective study of microscopic lymph node involvement of the hepatic pedicle during curative hepatectomy for colorectal metastases. Br J Surg 83:942–945

    Article  CAS  PubMed  Google Scholar 

  • Gai XD, Song Y, Li C, Lei YM, Yang B (2013) Potential role of plasmacytoid dendritic cells for FOXP3+ regulatory T cell development in human colorectal cancer and tumor draining lymph node. Pathol Res Pract 209:774–778

    Article  CAS  PubMed  Google Scholar 

  • Gayowski TJ, Iwatsuki S, Madariaga JR, Selby R, Todo S, Irish W, Starzl TE (1994) Experience in hepatic resection for metastatic colorectal cancer: analysis of clinical and pathologic risk factors. Surgery 116:703–710

    CAS  PubMed  PubMed Central  Google Scholar 

  • Gibbs JF, Weber TK, Rodriguez-Bigas MA, Driscoll DL, Petrelli NJ (1998) Intraoperative determinants of unresectability for patients with colorectal hepatic metastases. Cancer 82:1244–1249

    Article  CAS  PubMed  Google Scholar 

  • Gonzalez-Zubeldia I, Dotor J, Redrado M, Bleau A, Manrique I, de Aberasturi AL, Villable M, Calvo A (2015) Co-migration of colon cancer cells and CAFs induced by TGFβ1 enhances liver metastasis. Cell Tissue Res 359:829–839

    Google Scholar 

  • Grobmyer SR, Wang L, Gonen M, Fong Y, Klimstra D, D’Angelica M, DeMatteo RP, Schwartz L, Blumgart LH, Jarnagin WR (2006) Perihepatic lymph node assessment in patients undergoing partial hepatectomy for malignancy. Ann Surg 244:260–264

    Article  PubMed  PubMed Central  Google Scholar 

  • Gurusamy KS, Imber C, Davidson BR (2008) Management of the hepatic lymph nodes during resection of liver metastases from colorectal cancer: a systematic review. HPB Surg 2008:684150

    Article  PubMed  Google Scholar 

  • Hardy KJ, Wheatley IC, Anderson AI, Bond RJ (1976) The lymph nodes of the porta hepatis. Surg Gynecol Obstet 143:225–228

    CAS  PubMed  Google Scholar 

  • Harrell MI, Iritani BM, Ruddell A (2007) Tumor-induced sentinel lymph node lymphangiogenesis and increased lymph flow precede melanoma metastasis. Am J Pathol 170:774–786

    Article  PubMed  PubMed Central  Google Scholar 

  • He ZY, Wen H, Shi CB, Wang J (2010) Up-regulation of hnRNP A1, ezrin, tubulin β-2C and annexin A1 in sentinel lymph nodes of colorectal cancer. World J Gastroenterol 16:4670–4676

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Heys SD, Eremin O (1992) The relevance of tumor draining lymph nodes in cancer. Sur Gynecol Obstet 174:533–540

    CAS  Google Scholar 

  • Horst HA, Horny HP (1988) Cellular stromal reaction in lymph node metastases of human colorectal carcinomas. Hepatogastroenterology 35:140–143

    CAS  PubMed  Google Scholar 

  • Huth F (1974) Morphological aspects of the lymph vessel system of the liver (in German). Leber Magen Darm 4:262–273

    CAS  PubMed  Google Scholar 

  • Ishibashi K, Ohsawa T, Yokoyama M, Ishizuka N, Miyazaki T, Nakada H, Gonda T, Ishida H (2006) Hepatic lymph node involvement in patients with synchronous multiple liver metastases of colorectal cancer (in Japanese). Gan To Kagaku Ryoho 33:1834–1837

    PubMed  Google Scholar 

  • Ishida H, Ishibashi K, Ohsawa T, Okada N, Kumamoto K, Haga N (2011) Significance of hepatic lymph node metastasis in patients with unresectable synchronous liver metastasis of colorectal cancer. Int Surg 96:291–299

    Article  PubMed  Google Scholar 

  • Ito M, Mishima Y, Sato T (1991) An anatomical study of the lymphatic drainage of the gallbladder. Surg Radiol Anat 13:89–104

    Article  CAS  PubMed  Google Scholar 

  • Jaeck D (2003) The significance of hepatic pedicle lymph nodes metastases in surgical management of colorectal liver metastases of other liver malignancies. Ann Surg Oncol 10:1007–1011

    Article  PubMed  Google Scholar 

  • Kaler P, Owusu BY, Augenlicht L, Klampfer L (2014) The role of STAT1 for crosstalk between fibroblasts and colon cancer cells. Front Oncol 4:88

    Article  PubMed  PubMed Central  Google Scholar 

  • Kokudo et al (1999) http://www.ncbi.nlm.nih.gov/pubmed/1058765

  • Laurent C, Sa Cunha A, Rullier E, Smith D, Rullier A, Saric J (2004) Impact of microscopic hepatic lymph node involvement on survival after resection of colorectal liver metastasis. J Am Coll Surg 198:884–891

    Article  PubMed  Google Scholar 

  • Lores et al (1998) http://www.ncbi.nlm.nih.gov/pubmed/9852289

  • Lupinacci RM, Herman P, Coelho FC, Viana EF, D’Albuquerque LA, Cecconello I (2013) Diagnosis and impact of hilar lymph node micrometastases on the outcome of resected colorectal liver metastasis. Hepatogastroenterology 60:333–336

    CAS  PubMed  Google Scholar 

  • Lupinacci RM, Paye F, Coelho FF, Kruger JA, Herman P (2014) Lymphatic drainage of the liver and its implications in the management of colorectal cancer liver metastases. Updates Sur 66:239–245

    Article  Google Scholar 

  • Minagawa M, Makuuchi M, Torzilli G, Takayama T, Kawasaki S, Kosuge T, Yamamoto J et al (2000) Extension of the frontiers of surgical indications in the treatment of liver metastases from colorectal cancer: long-term results. Ann Surg 231:487–499

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Miranda E, Bianchi P, Destroy A, Morenghi E, Malesci A, Santoro A, Laghi L, Roncalli M (2013) Genetic and epigenetic alterations in primary colorectal cancers and related lymph node and liver metastases. Cancer 119:266–276

    Article  CAS  PubMed  Google Scholar 

  • Nakamura S, Yokoi Y, Suzuki S, Baba S, Muro H (1992) Results of extensive surgery for liver metastases in colorectal carcinoma. Br J Surg 79:35–38

    Article  CAS  PubMed  Google Scholar 

  • Nakamura S, Suzuki S, Konno H (1999) Resection of hepatic metastases of colorectal carcinoma: 20 years’ experience. J Hepato-Biliary-Pancreatic Surg 6:16–22

    Article  CAS  Google Scholar 

  • Nims TA (1984) Resection of the liver for metastatic cancer. Surg Gynecol Obstet 158:46–48

    CAS  PubMed  Google Scholar 

  • Ohlsson B, Stenram U, Tranberg KG (1998) Resection of colorectal liver metastases: 25-year experience. World J Surg 22:268–276

    Article  CAS  PubMed  Google Scholar 

  • Oussoultzoglou E, Romain B, Panaro F, Rosso E, Pessaux P, Bachellier P, Jaeck D (2009) Long-term survival after liver resection for colorectal liver metastases in patients with hepatic pedicle lymph nodes involvement in the era of new chemotherapy regimens. Ann Surg 249:879–886

    Article  PubMed  Google Scholar 

  • Pandey D (2008) Biological behavior of perihepatic lymph node metastasis and its impact on prognosis following liver resection for colorectal metastases. Ann Surg Oncol 15:2620

    Article  PubMed  Google Scholar 

  • Rodgers MS, McCall JL (2000) Surgery for colorectal liver metastases with hepatic lymph node involvement: a systematic review. Br J Surg 87:1142–1155

    Article  CAS  PubMed  Google Scholar 

  • Sapin MR, Usovich AK (1983) Anatomy and topography of the regional lymph nodes of the liver and gallbladder (in Russian). Vopr Onkol 29:45–52

    CAS  PubMed  Google Scholar 

  • Scheele J, Altendorf-Hofmann A, Stangl R, Schmidt K (1996) Surgical resection of colorectal liver metastases: gold standard for solitary and radically resectable lesions (in German). Swiss Surg (Suppl 4): 4–17.

    Google Scholar 

  • Schlereth SL, Refaian N, Iden S, Cursiefen C, Heindle LM (2014) Impact of the lymphangiogenic crosstalk in the tumor microenvironment on lymphatic cancer metastasis. Biomed Res Int 2014:639058

    Article  PubMed  PubMed Central  Google Scholar 

  • Szabo G, Magyar Z, Jakab F (1975) The lymphatic drainage of the liver capsule and hepatic parenchyma. Res Exp Med (Berlin) 166:193–200

    Article  CAS  Google Scholar 

  • Uesaka K, Yasui K, Morimoto T, Torii A, Yamamura Y, Kodera Y, Hirai T, Kato T, Kito T (1996) Visualization of routes of lymphatic drainage of the gallbladder with a carbon particle suspension. J Am Coll Surg 183:345–350

    CAS  PubMed  Google Scholar 

  • Viadana E, Au KL (1975) Patterns of metastases in adenocarcinomas of man. J Med 6:1–14

    CAS  PubMed  Google Scholar 

  • Viadana E, Bross IDJ, Pickren JW (1978) Cascade spread of blood-borne metastases in solid and nonsolid cancers of humans. In: Weiss L, Gilbert HA (eds) Pulmonary metastases. G.K. Hall, London

    Google Scholar 

  • Viana EF, Herman P, Siqueira SC, Taka T, Carvalho P, Coelho FF, Pugliese V, Saad WA, D’Albuquerque LA (2009) Lymphadenectomy in colorectal cancer liver metastases resection: incidence of hilar lymph nodes micrometastasis. J Surg Oncol 100:534–537

    Article  CAS  PubMed  Google Scholar 

  • Vines HWC (1949) Green’s manual of pathology, 17th edn. Bailiere, Tindall and Cox, London

    Google Scholar 

  • Wakai T, Shirai Y, Sakata J, Nagahashi M, Kaneko K, Hatakeyama K (2009) Hepatic lymph node dissection provides a survival benefit for patients with nodal disease of colorectal carcinoma liver metastases. Hepatogastroenterology 56:186–190

    PubMed  Google Scholar 

  • Wolodjko WP (1967) The lymphatic system of the human liver in relation to its segmentation (in German). Z Anat Entwicklungsgesch 126:154–171

    Article  CAS  PubMed  Google Scholar 

  • Yasui K, Hirai T, Kato T, Morimoto T, Tori T, Uesata K (1995) Major anatomical hepatic resection with regional lymph node dissection for liver metastases from colorectal cancer. J Hepato-Biliary-Pancreatic Surg 2:103–107

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Bern, Bern, Switzerland

    Arthur Zimmermann

Authors
  1. Arthur Zimmermann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Arthur Zimmermann .

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this entry

Cite this entry

Zimmermann, A. (2017). Metastatic Liver Disease: Hepatic Lymph Node Involvement. In: Tumors and Tumor-Like Lesions of the Hepatobiliary Tract. Springer, Cham. https://doi.org/10.1007/978-3-319-26956-6_110

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-26956-6_110

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-26954-2

  • Online ISBN: 978-3-319-26956-6

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation