Adequate lymph node dissection is essential for accurate nodal staging in intrahepatic cholangiocarcinoma: A population‐based study

作者：Jiang Zhu, Chang Liu, Hui Li, Haoyu Ren, Yunshi Cai, Tian Lan, Hong Wu · 发表于：Cancer Medicine · 年份：2023 · DOI：10.1002/cam4.5620 · 被引用次数：29 · 研究领域：Cholangiocarcinoma and Gallbladder Cancer Studies、Gallbladder and Bile Duct Disorders、Gastric Cancer Management and Outcomes

PURPOSE: To comprehensively investigate the implications of lymph node dissection (LND) and the prognostic impact of the number of lymph node (LN) metastases on survival in intrahepatic cholangiocarcinoma (ICC) using a large-scale study. METHODS: Patients who underwent surgical resection for ICC between 2004 and 2018 were identified from the Surveillance, Epidemiology, and End Results (SEER) registries. The Kaplan-Meier and log-rank tests were used to compare cancer-specific survival (CSS) and overall survival (OS) between different groups. Propensity score matching (PSM) and subgroup analyses were performed to balance potential confounding factors. A multivariate Cox proportional hazards regression model was used to identify prognostic factors of survival outcomes. Restricted cubic splines fitted in the Cox proportional hazard regression models were also conducted to examine associations between continuous variables and outcomes. RESULTS: In all, 1028 patients were enrolled. There were 652 (63.4%) patients undergoing LND, with lymph node metastasis (LNM) confirmed in 212 (32.5%) cases. Patients receiving LND did not show better survival outcomes than those receiving non-LND (NLND). We divided the LND group into two subgroups: patients with LNM (+) and those without LNM (-). Among these three groups, patients with LNM experienced the worst CSS and OS, while NLND patients had similar survival times to LNM (-) patients. Restricted cubic spline analysis indicated that an increas...