Tumor grade and sex should influence the utilization of portal lymphadenectomy for early stage intrahepatic cholangiocarcinoma

Sean P. Martin, Samantha Ruff, Laurence P. Diggs, Justin Drake, Reed I. Ayabe, Zachary J. Brown, Michael M. Wach, Seth M. Steinberg, Jeremy L. Davis, Jonathan M. Hernandez

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background: Portal lymphadenectomy for intrahepatic cholangiocarcinoma (ICC) is encouraged for staging purposes, though it is under-utilized for clinically early-stage tumors. We sought to determine if any factor knowable prior to resection influences rates of portal lymph node metastases. Methods: The Surveillance, Epidemiology, and End Results (SEER) Program (1973–2014) database was queried to identify patients with T1/T2 ICC undergoing resection. Patients were stratified by lymph node (LN) status. Patients deemed LN negative required examination of six or more LNs (AJCC guidelines). Results: One-hundred and fifty-two patients were included in the analysis (LN negative: 38, LN positive: 114). Patients with LN negative cancers experienced prolonged overall survival as compared to patients with positive LNs (median 77 months vs 19 months, respectively p < 0.001). Twelve patients had well-differentiated tumors (G1), 92 patients had moderately-differentiated tumors (G2) and 58 patients had poorly-differentiated tumors (G3). Tumor grade (OR 3.9, CI 1.1–13.7, p = 0.031) and male sex (OR 2.6, CI 1.1–6.1, p = 0.022) were associated with positive LNs on multivariable logistic regression analysis. Conclusion: Intermediate/High grade and male sex are associated with high rates of lymph node metastasis for patients with early-stage ICC, which portends abbreviated overall survival.

Original languageEnglish (US)
Pages (from-to)419-424
Number of pages6
JournalHPB
Volume21
Issue number4
DOIs
StatePublished - Apr 2019

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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