Clinical Significance of Lymph Node Metastasis in Patients Undergoing Partial Hepatectomy for Hepatocellular Carcinoma
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There are few detailed clinical reports about perihepatic lymph node (LN) assessment of hepatocellular carcinoma (HCC). The purpose of the present study was to evaluate the incidence, site, and impact on survival of LN metastasis in patients with HCC amenable to curative liver resection and routine regional lymphadenectomy.
From January 2001 to June 2004, a total of 523 HCC patients undergoing curative hepatic resection and routine regional lymphadenectomy were included in this study. The incidence, site of LN metastasis in HCC patients, and its influence on survival were analyzed.
A total of 3433 lymph nodes were dissected from the 523 patients enrolled in this study and examined by pathologists. Among these patients, LN metastasis was found in 39 (7.45%) patients. Hepatic pedicle, retropancreatic space, and common hepatic artery stations were conventionally removed. The incidence of LN metastasis in the hepatic pedicle station was higher than that in the other stations (p < 0.01) The overall cumulative survival rate was significantly worse for patients with LN metastasis than for those without LN metastasis (p < 0.01). The median survival time was 28 months among the patients with LN metastasis and 53 months among those without LN metastasis. Tumors had recurred in 82.05% (32/39) of patients with LN metastasis and in 57.64% (279/484) of those without LN metastasis (p < 0.01). Regional lymphadenectomy was considerably safe with a low intraoperative complication rate (0.95%).
Lymph node metastasis in patients with HCC is closely related to a lower survival rate. Regional lymph node dissection should always be performed to determine the precise stage of the disease. Hepatic resection with regional lymphadenectomy is a safe procedure in patients with HCC.
- 2.Ferlay J, Bray F, Pisani P, et al (2001) 2000: Cancer incidence, mortality and prevalence worldwide. Version 1.0. IARC Press, LyonGoogle Scholar
- 4.Hao XS, Chen KX, Wang PP et al (2005) Changes in survival patterns in urban Chinese patients with liver cancer. World J Gastroenterol 9:1212–1215Google Scholar
- 5.Sobin LH, Wittekind C (eds) (2001) International union against cancer (UICC): TNM classification of malignant tumors, 5th edn. New York, WileyGoogle Scholar
- 18.Japanese Society of Biliary Surgery (2001) General rules for surgical and pathological studies on cancer of biliary tract, 4th edn. Kanehara, TokyoGoogle Scholar
- 19.Fleming ID, Cooper JS, Henson DE et al (eds) (2001) American joint committee on cancer staging manual, 5th edn. Lippincott, Philadelphia, pp 97–101Google Scholar
- 22.Liver Cancer Study Group of Japan (1990) Primary liver cancer of Japan: clinicopathological features and results of surgical treatment. Ann Surg 211:277–287Google Scholar