Preoperative clinicopathological features of patients obtaining survival benefit from lymph node dissection in intrahepatic cholangiocarcinoma resection
Objective:To investigate the preoperative clinicopathological features of patients who obtained survival benefit from lymph node dissection in resection of intrahepatic cholangiocarcinoma (ICC).Methods:Clinical data of 415 patients who underwent ICC radical resection in 8 hospitals in China from January 2010 to December 2018 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 225 patients were male and 190 female,aged from 27 to 83 years, with a median age of 59 years. All patients were divided into the dissection and non-dissection groups according to whether intraoperative lymph node dissection was performed. Propensity score matching (PSM) was used to balance the differences between the dissection and non-dissection groups. Survival analysis was performed by Kaplan-Meier method and Log-rank test. Preoperative clinicopathological characteristics of patients obtaining survival benefit in the dissection group were analyzed.Results:Prior to PSM, 283 patients were allocated in the dissection group and 132 cases in the non-dissection group. After 1∶1 PSM, 228 patients were selected, with 114 cases in each group. The median survival in the dissection and non-dissection groups was 35.4 and 25.0 months, and the overall survival rate in the dissection group was significantly higher than that in the non-dissection group (χ2=5.404, P<0.05). Glisson's capsule invasion,CA19-9>37 kU/L, abnormal neutrophil and lymphocyte count were the preoperative clinicopathological features of ICC patients obtaining survival benefit from lymph node dissection (χ2=9.548, 4.800, 13.715, 13.412; P<0.05).Conclusions:Lymph node dissection in ICC radical resection can bring survival benefit to patients with hepatic capsule invasion, preoperative CA19-9>37 kU/L, abnormal neutrophil and lymphocyte count.
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