Comparative analysis of lymph node metastasis and dissection in patients with intrahepatic cholangio-carcinoma at various anatomical locations and their impact on prognosis
Objective To study and compare the impact of lymph node metastasis and dissection on the prognosis of intrahepatic cholangiocarcinoma(ICC)patients at different anatomical locations,as well as the effect on prognosis.Methods A retrospective analysis was conducted on the clinical data of 150 ICC patients who underwent radical surgical resection at the 904th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army from September 2017 to September 2020.Among them,86 were males and 64 were females,with the age of(56.2±12.9)years.Differences in albumin-bilirubin(ALBI)grade,preoperative lymph node metastasis risk,number of lymph nodes dissected,lymph node metastasis,and postoperative survival between peripheral and central ICC patients were compared to analyze the impact of lymph node dissection on the prognosis of ICC patients at different locations.Results There were statisti-cally significant differences in ALBI grade,preoperative lymph node metastasis risk,the number of lymph nodes dissected,and lymph node metastasis between 98 cases of peripheral ICC and 52 cases of central ICC(all P＜0.05).The 3-year overall survival rates for peripheral and central ICC patients were 30.6％and 15.4％,respectively,with a statistically significant difference(x2=8.46,P=0.004).Among central ICC patients,the 3-year overall survival rates for those with ≥6 lymph nodes dissected and＜6 lymph nodes dis-sected were 16.7％and 12.5％,respectively,with a statistically significant difference(x2=3.96,P=0.046).In the high-risk central ICC patients with preoperative lymph node metastasis,the 3-year over-all survival rate of ≥6 lymph nodes dissection(n=22)and＜6 lymph nodes dissection(n=12)were 13.6％and 8.3％,respectively,with statistical significance(x2=5.55,P=0.019).Conclusions The prognosis of peripheral ICC patients is better than that of central ICC patients.For central ICC patients with a high preoperative lymph node metastasis risk,adequate lymph node dissection can lead to a better progno-sis.
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