Lymph Node Examination and Patterns of Nodal Metastasis Among Patients with Left- Versus Right-Sided Intrahepatic Cholangiocarcinoma After Major Curative-Intent Resection

Xu-Feng Zhang; Feng Xue; Matthew Weiss; Irinel Popescu; Hugo P Marques; Luca Aldrighetti; Shishir K Maithel; Carlo Pulitano; Todd W Bauer; Feng Shen; George A Poultsides; François Cauchy; Guillaume Martel; B Groot Koerkamp; Endo Itaru; Yi Lv; Timothy M Pawlik

doi:10.1245/s10434-022-12797-2

Lymph Node Examination and Patterns of Nodal Metastasis Among Patients with Left- Versus Right-Sided Intrahepatic Cholangiocarcinoma After Major Curative-Intent Resection

Xu-Feng Zhang
, Feng Xue
, Matthew Weiss
, Irinel Popescu
, Hugo P Marques
, Luca Aldrighetti
, Shishir K Maithel
, Carlo Pulitano
, Todd W Bauer
, Feng Shen
, George A Poultsides
, François Cauchy
, Guillaume Martel
, B Groot Koerkamp
, Endo Itaru
, Yi Lv
, Timothy M Pawlik

Surgery

The First Affiliated Hospital of Xi'an Jiaotong University
Johns Hopkins Hospital
Fundeni Clinical Institute
Hospital Curry Cabral
Department of Orthopedic Surgery
Emory University
University of Sydney and Woolcock Emphysema Centre and Sydney Local Health District
University of Virginia
Eastern Hepatobiliary Surgery Hospital
Stanford University
Beaujon Hospital
University of Ottawa
Yokohama City University Graduate School of Medicine
The James Comprehensive Cancer Center

Research output: Contribution to journal › Article › Academic › peer-review

7 Citations (Scopus)

Abstract

BACKGROUND: We sought to investigate whether the unique lateral patterns of lymphatic drainage impacted lymphadenectomy (LND), lymph node metastasis (LNM), and long-term survival of patients after curative hemi-hepatectomy for left- versus right-sided intrahepatic cholangiocarcinoma (ICC).

METHODS: Data on patients who underwent curative hemi-hepatectomy for left- or right-sided ICC were collected from 15 high-volume centers worldwide, as well as from the Surveillance, Epidemiology, and End Results (SEER) registry. Primary outcomes included overall survival (OS) and disease-free survival (DFS).

RESULTS: Among 697 patients identified from the multi-institutional database, patients who underwent hemi-hepatectomy for left-sided ICC (n = 363, 52.1%) were more likely to have an increased number of LND versus patients with right-sided ICC (n = 334, 47.9%) (median, left 5 versus right 3, p = 0.012), although the frequency (left 66.4% versus right 63.8%, p = 0.469) and station (beyond station no. 12, left 25.3% versus right 21.1%, p = 0.293) were similar. Consequently, left-sided ICC was associated with higher incidence of LNM (left 33.3% versus right 25.7%, p = 0.036), whereas the station and number of LNM were not different (both p > 0.1). There was no difference in OS (median, left 34.9 versus right 29.6 months, p = 0.130) or DFS (median, left 14.5 versus right 15.2 months, p = 0.771) among patients who underwent hemi-hepatectomy for left- versus right-sided ICC, which were also verified in the SEER dataset. LNM beyond station no. 12 was associated with even worse long-term survival versus LNM within station no. 12 among patients with either left- or right-sided ICC after curative-intent resection (all p < 0.05).

CONCLUSIONS: The unique lateral patterns of lymphatic drainage were closely related to utilization of LND, as well as LNM of left- versus right-sided ICC.

Original language	English
Pages (from-to)	1424-1433
Number of pages	10
Journal	Annals of Surgical Oncology
Volume	30
Issue number	3
Early online date	18 Nov 2022
DOIs	https://doi.org/10.1245/s10434-022-12797-2
Publication status	Published - Mar 2023

Bibliographical note

Publisher Copyright:
© 2022, Society of Surgical Oncology.

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10.1245/s10434-022-12797-2

Cite this

Zhang, X.-F., Xue, F., Weiss, M., Popescu, I., Marques, H. P., Aldrighetti, L., Maithel, S. K., Pulitano, C., Bauer, T. W., Shen, F., Poultsides, G. A., Cauchy, F., Martel, G., Koerkamp, B. G., Itaru, E., Lv, Y., & Pawlik, T. M. (2023). Lymph Node Examination and Patterns of Nodal Metastasis Among Patients with Left- Versus Right-Sided Intrahepatic Cholangiocarcinoma After Major Curative-Intent Resection. Annals of Surgical Oncology, 30(3), 1424-1433. https://doi.org/10.1245/s10434-022-12797-2

@article{abba26e8c72f4f2396724ebe12d7cdac,

title = "Lymph Node Examination and Patterns of Nodal Metastasis Among Patients with Left- Versus Right-Sided Intrahepatic Cholangiocarcinoma After Major Curative-Intent Resection",

abstract = "BACKGROUND: We sought to investigate whether the unique lateral patterns of lymphatic drainage impacted lymphadenectomy (LND), lymph node metastasis (LNM), and long-term survival of patients after curative hemi-hepatectomy for left- versus right-sided intrahepatic cholangiocarcinoma (ICC).METHODS: Data on patients who underwent curative hemi-hepatectomy for left- or right-sided ICC were collected from 15 high-volume centers worldwide, as well as from the Surveillance, Epidemiology, and End Results (SEER) registry. Primary outcomes included overall survival (OS) and disease-free survival (DFS).RESULTS: Among 697 patients identified from the multi-institutional database, patients who underwent hemi-hepatectomy for left-sided ICC (n = 363, 52.1\%) were more likely to have an increased number of LND versus patients with right-sided ICC (n = 334, 47.9\%) (median, left 5 versus right 3, p = 0.012), although the frequency (left 66.4\% versus right 63.8\%, p = 0.469) and station (beyond station no. 12, left 25.3\% versus right 21.1\%, p = 0.293) were similar. Consequently, left-sided ICC was associated with higher incidence of LNM (left 33.3\% versus right 25.7\%, p = 0.036), whereas the station and number of LNM were not different (both p > 0.1). There was no difference in OS (median, left 34.9 versus right 29.6 months, p = 0.130) or DFS (median, left 14.5 versus right 15.2 months, p = 0.771) among patients who underwent hemi-hepatectomy for left- versus right-sided ICC, which were also verified in the SEER dataset. LNM beyond station no. 12 was associated with even worse long-term survival versus LNM within station no. 12 among patients with either left- or right-sided ICC after curative-intent resection (all p < 0.05).CONCLUSIONS: The unique lateral patterns of lymphatic drainage were closely related to utilization of LND, as well as LNM of left- versus right-sided ICC.",

author = "Xu-Feng Zhang and Feng Xue and Matthew Weiss and Irinel Popescu and Marques, \{Hugo P\} and Luca Aldrighetti and Maithel, \{Shishir K\} and Carlo Pulitano and Bauer, \{Todd W\} and Feng Shen and Poultsides, \{George A\} and Fran{\c c}ois Cauchy and Guillaume Martel and Koerkamp, \{B Groot\} and Endo Itaru and Yi Lv and Pawlik, \{Timothy M\}",

note = "Publisher Copyright: {\textcopyright} 2022, Society of Surgical Oncology.",

year = "2023",

month = mar,

doi = "10.1245/s10434-022-12797-2",

language = "English",

volume = "30",

pages = "1424--1433",

journal = "Annals of Surgical Oncology",

issn = "1068-9265",

publisher = "Springer Science+Business Media",

number = "3",

}

Zhang, X-F, Xue, F, Weiss, M, Popescu, I, Marques, HP, Aldrighetti, L, Maithel, SK, Pulitano, C, Bauer, TW, Shen, F, Poultsides, GA, Cauchy, F, Martel, G, Koerkamp, BG, Itaru, E, Lv, Y & Pawlik, TM 2023, 'Lymph Node Examination and Patterns of Nodal Metastasis Among Patients with Left- Versus Right-Sided Intrahepatic Cholangiocarcinoma After Major Curative-Intent Resection', Annals of Surgical Oncology, vol. 30, no. 3, pp. 1424-1433. https://doi.org/10.1245/s10434-022-12797-2

Lymph Node Examination and Patterns of Nodal Metastasis Among Patients with Left- Versus Right-Sided Intrahepatic Cholangiocarcinoma After Major Curative-Intent Resection. / Zhang, Xu-Feng; Xue, Feng; Weiss, Matthew et al.
In: Annals of Surgical Oncology, Vol. 30, No. 3, 03.2023, p. 1424-1433.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Lymph Node Examination and Patterns of Nodal Metastasis Among Patients with Left- Versus Right-Sided Intrahepatic Cholangiocarcinoma After Major Curative-Intent Resection

AU - Zhang, Xu-Feng

AU - Xue, Feng

AU - Weiss, Matthew

AU - Popescu, Irinel

AU - Marques, Hugo P

AU - Aldrighetti, Luca

AU - Maithel, Shishir K

AU - Pulitano, Carlo

AU - Bauer, Todd W

AU - Shen, Feng

AU - Poultsides, George A

AU - Cauchy, François

AU - Martel, Guillaume

AU - Koerkamp, B Groot

AU - Itaru, Endo

AU - Lv, Yi

AU - Pawlik, Timothy M

PY - 2023/3

Y1 - 2023/3

N2 - BACKGROUND: We sought to investigate whether the unique lateral patterns of lymphatic drainage impacted lymphadenectomy (LND), lymph node metastasis (LNM), and long-term survival of patients after curative hemi-hepatectomy for left- versus right-sided intrahepatic cholangiocarcinoma (ICC).METHODS: Data on patients who underwent curative hemi-hepatectomy for left- or right-sided ICC were collected from 15 high-volume centers worldwide, as well as from the Surveillance, Epidemiology, and End Results (SEER) registry. Primary outcomes included overall survival (OS) and disease-free survival (DFS).RESULTS: Among 697 patients identified from the multi-institutional database, patients who underwent hemi-hepatectomy for left-sided ICC (n = 363, 52.1%) were more likely to have an increased number of LND versus patients with right-sided ICC (n = 334, 47.9%) (median, left 5 versus right 3, p = 0.012), although the frequency (left 66.4% versus right 63.8%, p = 0.469) and station (beyond station no. 12, left 25.3% versus right 21.1%, p = 0.293) were similar. Consequently, left-sided ICC was associated with higher incidence of LNM (left 33.3% versus right 25.7%, p = 0.036), whereas the station and number of LNM were not different (both p > 0.1). There was no difference in OS (median, left 34.9 versus right 29.6 months, p = 0.130) or DFS (median, left 14.5 versus right 15.2 months, p = 0.771) among patients who underwent hemi-hepatectomy for left- versus right-sided ICC, which were also verified in the SEER dataset. LNM beyond station no. 12 was associated with even worse long-term survival versus LNM within station no. 12 among patients with either left- or right-sided ICC after curative-intent resection (all p < 0.05).CONCLUSIONS: The unique lateral patterns of lymphatic drainage were closely related to utilization of LND, as well as LNM of left- versus right-sided ICC.

AB - BACKGROUND: We sought to investigate whether the unique lateral patterns of lymphatic drainage impacted lymphadenectomy (LND), lymph node metastasis (LNM), and long-term survival of patients after curative hemi-hepatectomy for left- versus right-sided intrahepatic cholangiocarcinoma (ICC).METHODS: Data on patients who underwent curative hemi-hepatectomy for left- or right-sided ICC were collected from 15 high-volume centers worldwide, as well as from the Surveillance, Epidemiology, and End Results (SEER) registry. Primary outcomes included overall survival (OS) and disease-free survival (DFS).RESULTS: Among 697 patients identified from the multi-institutional database, patients who underwent hemi-hepatectomy for left-sided ICC (n = 363, 52.1%) were more likely to have an increased number of LND versus patients with right-sided ICC (n = 334, 47.9%) (median, left 5 versus right 3, p = 0.012), although the frequency (left 66.4% versus right 63.8%, p = 0.469) and station (beyond station no. 12, left 25.3% versus right 21.1%, p = 0.293) were similar. Consequently, left-sided ICC was associated with higher incidence of LNM (left 33.3% versus right 25.7%, p = 0.036), whereas the station and number of LNM were not different (both p > 0.1). There was no difference in OS (median, left 34.9 versus right 29.6 months, p = 0.130) or DFS (median, left 14.5 versus right 15.2 months, p = 0.771) among patients who underwent hemi-hepatectomy for left- versus right-sided ICC, which were also verified in the SEER dataset. LNM beyond station no. 12 was associated with even worse long-term survival versus LNM within station no. 12 among patients with either left- or right-sided ICC after curative-intent resection (all p < 0.05).CONCLUSIONS: The unique lateral patterns of lymphatic drainage were closely related to utilization of LND, as well as LNM of left- versus right-sided ICC.

UR - https://www.scopus.com/pages/publications/85141955878

U2 - 10.1245/s10434-022-12797-2

DO - 10.1245/s10434-022-12797-2

M3 - Article

C2 - 36400889

AN - SCOPUS:85141955878

SN - 1068-9265

VL - 30

SP - 1424

EP - 1433

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

IS - 3

ER -

Lymph Node Examination and Patterns of Nodal Metastasis Among Patients with Left- Versus Right-Sided Intrahepatic Cholangiocarcinoma After Major Curative-Intent Resection

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