Skip to main content
SpringerLink
Log in

Number of Lymph Node Metastases Is a Significant Prognostic Factor in Intrahepatic Cholangiocarcinoma

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Intrahepatic cholangiocarcinoma (IHCC) is a rare primary hepatic tumor. Outcomes after resection and the use of lymph node dissection have not been well described. From a prospective database, we identified 53 patients with IHCC who underwent exploration between April 1983 and March 2004. Hepatic resection was performed in 44 patients, 30 of whom underwent lymph node dissection. Clinicopathological features and outcomes were analyzed. The actuarial 1-year survival was 66.2% in resected patients, compared to 0% in unresectable patients (p < 0.0001), with a 50% overall survival of 21.5 months and 3.1 months, respectively. The actuarial 3-year and 5-year overall survival rates in resected patients were 38.3% and 26.3%, respectively. Univariate analysis revealed that factors associated with poor overall survival included multiple tumors, extrahepatic bile duct involvement, noncurative resection, and involvement of lymph nodes. Multivariate analysis in resected patients revealed that multiple tumors (p < 0.0074) and non-curative resection (p = 0.0068) were significant risk factors for poor overall survival. The survival rate in patients with three or more positive nodes was significantly lower than in those with fewer than three (p < 0.0001). Three patients with solitary tumors and one or two involved lymph nodes have survived beyond 4 years after extended lobectomy with systemic lymphadenectomy. Curative resection, single tumor, and fewer than two lymph node metastases were prognostic factors for good outcome. Curative resection with lymph node dissection improved survival in patients with no more than two positive lymph nodes.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1
Figure 2

Similar content being viewed by others

References

  1. I Ikai Y Itai K Okita et al. (2004) ArticleTitleReport of the 15th follow-up survey of primary liver cancer Hepatol. Res. 28 21 Occurrence Handle10.1016/j.hepres.2003.08.002 Occurrence Handle14734147

    Article  PubMed  Google Scholar 

  2. DM Nagorney JH Donohue MB Farnell et al. (1993) ArticleTitleOutcomes after curative resections of cholangiocarcinoma Arch. Surg. 128 871 Occurrence Handle8393652

    PubMed  Google Scholar 

  3. Y Kawarada K Yamagiwa BC. Das (2002) ArticleTitleAnalysis of the relationships between clinicopathologic factors and survival time in intrahepatic cholangiocarcinoma Am. J. Surg. 183 679 Occurrence Handle10.1016/S0002-9610(02)00853-X Occurrence Handle12095601

    Article  PubMed  Google Scholar 

  4. SM Weber WR Jarnagin D Kimstra et al. (2001) ArticleTitleIntrahepatic cholangiocarcinoma: resectability, recurrence pattern, and outcomes J. Am. Coll. Surg. 193 384 Occurrence Handle10.1016/S1072-7515(01)01016-X Occurrence Handle11584966

    Article  PubMed  Google Scholar 

  5. KM Chu ECS Lai S Al-Hadeedi et al. (1997) ArticleTitleIntrahepatic cholangiocarcinoma World J. Surg. 21 301 Occurrence Handle10.1007/s002689900233 Occurrence Handle9015175

    Article  PubMed  Google Scholar 

  6. M Shimada Y Yamashita S Aishima et al. (2001) ArticleTitleValue of lymph node dissection during resection of intrahepatic cholangiocarcinoma Br. J. Surg. 88 1463 Occurrence Handle10.1046/j.0007-1323.2001.01879.x Occurrence Handle11683741

    Article  PubMed  Google Scholar 

  7. T Tsuji T Hiraoka K Kanemitsu et al. (2001) ArticleTitleLymphatic spreading pattern of intrahepatic cholangiocarcinoma Surgery 129 401 Occurrence Handle10.1067/msy.2001.111873 Occurrence Handle11283529

    Article  PubMed  Google Scholar 

  8. M Yamamoto K Takasaki T Imaizumi et al. (2002) ArticleTitleA long-term survivor of intrahepatic cholangiocarcinoma with lymph node metastasis: a case report Jpn. J. Clin. Oncol. 32 206 Occurrence Handle10.1093/jjco/hyf044 Occurrence Handle12110637

    Article  PubMed  Google Scholar 

  9. InstitutionalAuthorNameLiver Cancer Study Group of Japan (1997) Classification of Primary Liver Cancer EditionNumber1st English ed Kanehara Tokyo 6–7

    Google Scholar 

  10. S Isaji Y Kawarada H Taoka et al. (1999) ArticleTitleClinicopathological features and outcome of hepatic resection for intrahepatic cholangiocarcinoma in Japan J. Hepatobil. Pancreat. Surg. 6 108 Occurrence Handle10.1007/s005340050092

    Article  Google Scholar 

  11. MJ Lieser MK Barry C Rowland et al. (1998) ArticleTitleSurgical management of intrahepatic cholangiocarcinoma: a 31-year experience J. Hepatobil. Pancreat. Surg. 5 14

    Google Scholar 

  12. M Ohtsuka H Ito F Kimura et al. (2002) ArticleTitleResults of surgical tratment for intrahepatic cholangiocarcinoma and clinicopathological factors influencing survival Br. J. Surg. 89 1525 Occurrence Handle10.1046/j.1365-2168.2002.02268.x Occurrence Handle12445060

    Article  PubMed  Google Scholar 

  13. S Suzuki T Sakaguchi Y Yokoi et al. (2002) ArticleTitleClinicopathological prognostic factors and impact of surgical treatment of mass-forming intrahepatic cholangiocarcinoma World J. Surg. 26 687 Occurrence Handle10.1007/s00268-001-0291-1 Occurrence Handle12053220

    Article  PubMed  Google Scholar 

  14. FA Casavilla JW Marsh S Iwatsuki et al. (1997) ArticleTitleHepatic resection and transplantation for peripheral cholangiocarcinoma J. Am. Coll. Surg. 185 429 Occurrence Handle10.1016/S1072-7515(97)00088-4 Occurrence Handle9358085

    Article  PubMed  Google Scholar 

  15. K Hirohashi T Uenishi S Kubo et al. (2002) ArticleTitleMacroscopic types of intrahepatic cholangiocarcinoma: clinicopathologic features and surgical outcomes Hepatogastroenterology 49 326 Occurrence Handle11995443

    PubMed  Google Scholar 

  16. B Fisher M Bauer DL Wickerham et al. (1983) ArticleTitleRelation of number of positive axillary nodes to the prognosis of patients with primary breast cancer. An NSABP uptade Cancer 52 1551 Occurrence Handle6352003

    PubMed  Google Scholar 

  17. JR. Jass (1986) ArticleTitleLymphocytic infiltration and survival in rectal cancer J. Clin. Pathol. 39 585 Occurrence Handle3722412

    PubMed  Google Scholar 

  18. S Shimada Y Yagi U Honmyo et al. (2001) ArticleTitleInvolvement of three or more lymph nodes predicts poor prognosis in submucosal gastric carcinoma Gastric Cancer 4 54 Occurrence Handle11706761

    PubMed  Google Scholar 

  19. T Uenishi K Hirohashi S Kubo et al. (2001) ArticleTitleHistologic factors affecting prognosis following hepatectomy for intraheapic cholangiocarcinoma World J. Surg. 25 865 Occurrence Handle10.1007/s00268-001-0042-3 Occurrence Handle11572025

    Article  PubMed  Google Scholar 

  20. M Yamamoto K Takasaki T. Yoshikawa (1999) ArticleTitleExtended resection for intrahepatic cholangiocarcinoma in Japan J. Hepatobil. Pancreat. Surg. 6 117 Occurrence Handle10.1007/s005340050093

    Article  Google Scholar 

  21. J Okami K Dohno M Sakon et al. (2000) ArticleTitleGenetic detection for micrometastasis in lymph node of biliary tract carcinoma Clin. Cancer Res. 6 2326 Occurrence Handle10873083

    PubMed  Google Scholar 

  22. LH Sobin C Wittekin (1997) UICC TNM classification of malignant tumours EditionNumber5th ed. Wiley-Liss New York 74–77

    Google Scholar 

Download references

Acknowledgments

The authors thanks the staff of the First Department of Surgery, Hokkaido University Medical Hospital, for their clinical assistance, and Ms. Nancy Ehrlich Lapid for editorial assistance.

Author information

Authors and Affiliations

  1. Department of General Surgery, Hokkaido University, Graduate School of Medicine, N15W7, Kita-ku, Sapporo, Japan

    Takahito Nakagawa M.D., Toshiya Kamiyama M.D., Nobuaki Kurauchi M.D., Michiaki Matsushita M.D., Kazuaki Nakanishi M.D., Hirofumi Kamachi M.D., Takeaki Kudo M.D. & Satoru Todo M.D.

Authors
  1. Takahito Nakagawa M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toshiya Kamiyama M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nobuaki Kurauchi M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michiaki Matsushita M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kazuaki Nakanishi M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hirofumi Kamachi M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Takeaki Kudo M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Satoru Todo M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Takahito Nakagawa M.D..

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nakagawa, T., Kamiyama, T., Kurauchi, N. et al. Number of Lymph Node Metastases Is a Significant Prognostic Factor in Intrahepatic Cholangiocarcinoma. World J. Surg. 29, 728–733 (2005). https://doi.org/10.1007/s00268-005-7761-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-005-7761-9

Keywords

Search

Navigation