Predicting Lymph Node Metastasis in Intrahepatic Cholangiocarcinoma.

Published on May 1, 2021in Journal of Gastrointestinal Surgery2.573
· DOI :10.1007/S11605-020-04720-5
Diamantis I. Tsilimigras21
Estimated H-index: 21
(The Ohio State University Wexner Medical Center),
Kota Sahara15
Estimated H-index: 15
(The Ohio State University Wexner Medical Center)
+ 18 AuthorsTimothy M. Pawlik118
Estimated H-index: 118
(The Ohio State University Wexner Medical Center)
Sources
Abstract
BACKGROUND The objective of the current study was to develop a model to predict the likelihood of occult lymph node metastasis (LNM) prior to resection of intrahepatic cholangiocarcinoma (ICC). METHODS Patients who underwent hepatectomy for ICC between 2000 and 2017 were identified using a multi-institutional database. A novel model incorporating clinical and preoperative imaging data was developed to predict LNM. RESULTS Among 980 patients who underwent resection of ICC, 190 (19.4%) individuals had at least one LNM identified on final pathology. An enhanced imaging model incorporating clinical and imaging data was developed to predict LNM ( https://k-sahara.shinyapps.io/ICC_imaging/ ). The performance of the enhanced imaging model was very good in the training data set (c-index 0.702), as well as the validation data set with bootstrapping resamples (c-index 0.701) and outperformed the preoperative imaging alone (c-index 0.660). The novel model predicted both 5-year overall survival (OS) (low risk 48.4% vs. high risk 18.4%) and 5-year disease-specific survival (DSS) (low risk 51.9% vs. high risk 25.2%, both p 0.05). CONCLUSION This tool may represent an opportunity to stratify prognosis of Nx patients and can help inform clinical decision-making prior to resection of ICC.
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Background Accurate risk stratification and patient selection is necessary to identify patients who will benefit the most from surgery or be better treated with other non-surgical treatment strategies. We sought to identify which patients in the preoperative setting would likely derive the most or least benefit from resection of intrahepatic cholangiocarcinoma (ICC).
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Objectives:To determine the prognostic implication of the number and station of LNM, and the minimal number of LNs needed for evaluation to accurately stage patients with intrahepatic cholangiocarcinoma (ICC).Background:Impact of the number and station of LNM on long-term survival, and the minimal n
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Background: Lymph node metastasis (LNM) drastically reduces survival after resection of intrahepatic cholangiocarcinoma (IHC). Optimal treatment is ill-defined, and it is unclear if tumor mutational profiling can support treatment decisions. Methods: Patients with liver-limited IHC with or without LNM treated with resection (N=237), hepatic arterial infusion chemotherapy (HAIC) (N=196), or systemic chemotherapy alone (SYS) (N=140) at our institution between 2000-2018 were included. Genomic seque...
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