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Purpose <p>Lymph node metastasis (LNM) is strongly associated with a poor survival in patients with intrahepatic cholangiocarcinoma (ICC). However, the indications for lymph node dissection (LND) are controversial. This study assessed the accuracy of preoperative imaging for detecting LNM.</p> Methods <p>Eighty-nine patients who underwent curative resection for ICC between 2001 and 2022 were enrolled and analyzed retrospectively. Lymph node status was evaluated preoperatively using contrast-enhanced computed tomography (CT) and positron emission tomography (PET)/CT. Patients were grouped according to their LND status (LND or no LND). Patients in the LND group were further grouped according to pathological LNM status (pN+, LNM-positive; and pN0, LNM-negative).</p> Results <p>Adequate LND was performed in 44 (49.4%) patients, among whom LNM was diagnosed in 17 (38.6%). The 3-year overall survival rates in patients with LND/pN+, LND/pN0, and no LND were 16.2%, 70.0%, and 70.7%, respectively. The corresponding 3-year recurrence-free survival rates were 11.8, 52.6, and 42.6%, respectively. A lymph node diameter &gt; 8&#xa0;mm on preoperative CT was an independent predictor of LNM. The maximum standardized uptake value (SUVmax) on PET/CT was significantly associated with LNM.</p> Conclusion <p>Lymph node diameter and SUVmax predicted LNM in patients with resectable ICC. A preoperative lymph node evaluation can ensure optimal treatment outcomes.</p>

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Survival benefit of lymph node dissection and prediction of lymph node metastasis in patients with intrahepatic cholangiocarcinoma

  • 期刊论文

  • 发表日期：

    2025年11月6日

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  • Kyohei Yugawa,
  • Shinji Itoh,
  • Takuma Izumi,
  • Takeo Toshima,
  • Takashi Motomura,
  • Sunao Fujiyoshi,
  • Norifumi Iseda,
  • Yuriko Tsutsui,
  • Tomoharu Yoshizumi

摘要

Purpose

Lymph node metastasis (LNM) is strongly associated with a poor survival in patients with intrahepatic cholangiocarcinoma (ICC). However, the indications for lymph node dissection (LND) are controversial. This study assessed the accuracy of preoperative imaging for detecting LNM.

Methods

Eighty-nine patients who underwent curative resection for ICC between 2001 and 2022 were enrolled and analyzed retrospectively. Lymph node status was evaluated preoperatively using contrast-enhanced computed tomography (CT) and positron emission tomography (PET)/CT. Patients were grouped according to their LND status (LND or no LND). Patients in the LND group were further grouped according to pathological LNM status (pN+, LNM-positive; and pN0, LNM-negative).

Results

Adequate LND was performed in 44 (49.4%) patients, among whom LNM was diagnosed in 17 (38.6%). The 3-year overall survival rates in patients with LND/pN+, LND/pN0, and no LND were 16.2%, 70.0%, and 70.7%, respectively. The corresponding 3-year recurrence-free survival rates were 11.8, 52.6, and 42.6%, respectively. A lymph node diameter > 8 mm on preoperative CT was an independent predictor of LNM. The maximum standardized uptake value (SUVmax) on PET/CT was significantly associated with LNM.

Conclusion

Lymph node diameter and SUVmax predicted LNM in patients with resectable ICC. A preoperative lymph node evaluation can ensure optimal treatment outcomes.