Impact of positive lymph nodes and resection margin status on the overall survival of patients with resected perihilar cholangiocarcinoma: The ENSCCA registry
Authors
Nooijen, L. E.Banales, J. M.
de Boer, M. T.
Braconi, C.
Folseraas, T.
Forner, A.
Holowko, W.
Hoogwater, F. J. H.
Klümpen, H. J.
Groot Koerkamp, B.
Lamarca, Angela
La Casta, A.
López-López, F.
Izquierdo-Sánchez, L.
Scheiter, A.
Utpatel, K.
Swijnenburg, R. J.
Kazemier, G.
Erdmann, J. I.
Affiliation
Department of Surgery, Amsterdam UMC-Location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The NetherlandsIssue Date
2022
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Background: Lymph node metastasis and positive resection margins have been reported to be major determinants of overall survival (OS) and poor recurrence-free survival (RFS) for patients who underwent resection for perihilar cholangiocarcinoma (pCCA). However, the prognostic value of positive lymph nodes independently from resection margin status on OS has not been evaluated. Methods: From the European Cholangiocarcinoma (ENSCCA) registry, patients who underwent resection for pCCA between 1994 and 2021 were included in this retrospective cohort study. The primary outcome was OS stratified for resection margin and lymph node status. The secondary outcome was recurrence-free survival. Results: A total of 325 patients from 11 different centers and six European countries were included. Of these, 194 (59.7%) patients had negative resection margins. In 113 (34.8%) patients, positive lymph nodes were found. Lymph node status, histological grade, and ECOG performance status were independent prognostic factors for survival. The median OS for N0R0, N0R1, N+R0, and N+R1 was 38, 30, 18, and 12 months, respectively (p < 0.001). Conclusion: These data indicate that in the presence of positive regional lymph nodes, resection margin status does not determine OS or RFS in patients with pCCA. Achieving negative margins in patients with positive nodes should not come at the expense of more extensive surgery and associated higher mortality.Citation
Nooijen LE, Banales JM, de Boer MT, Braconi C, Folseraas T, Forner A, et al. Impact of Positive Lymph Nodes and Resection Margin Status on the Overall Survival of Patients with Resected Perihilar Cholangiocarcinoma: The ENSCCA Registry. Vol. 14, Cancers. MDPI AG; 2022. p. 2389.Journal
CancersDOI
10.3390/cancers14102389PubMed ID
35625993Additional Links
https://dx.doi.org/10.3390/cancers14102389Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.3390/cancers14102389
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