Surgical resection of lymph node positive intrahepatic cholangiocarcinoma may not improve survival

Scott Kizy, Ariella M. Altman, Schelomo Marmor, Keith Wirth, Jane Y. Ching Hui, Todd M Tuttle, Jason W Denbo, Eric H Jensen

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Background: Nodal positivity is a predictor of poor survival following resection for intrahepatic cholangiocarcinoma (ICC). The aim of this study was to evaluate the impact of surgical resection on survival in patients with lymph node (LN) positive ICC. Methods: An augmented version of the Surveillance, Epidemiology, and End Results program database was utilized to identify patients with LN-positive ICC without distant metastases from 2000 to 2014. Patients were stratified by treatment: chemotherapy alone or surgical resection with/without chemotherapy. Survival was evaluated using Kaplan–Meier and Cox proportional hazard models. Results: 169 patients who underwent treatment for LN-positive ICC were identified. 88% underwent surgical resection and 12% underwent chemotherapy alone. The median survival for patients who underwent surgical resection was not different from patients treated with chemotherapy alone (19 months 95% Confidence Interval (CI) 17–33 versus 20 months CI 10–27, p = 0.323). A cox-proportional hazard ratio model demonstrated that black race was associated with worse survival (p < 0.05), while surgical resection was not independently associated with survival. Conclusion: Surgical resection for patients with LN-positive ICC may not improve survival compared to chemotherapy alone. Pathologic LN evaluation should be performed prior to surgical resection, to improve patient selection and ensure receipt of optimal therapy.

Original languageEnglish (US)
Pages (from-to)235-241
Number of pages7
JournalHPB
Volume21
Issue number2
DOIs
StatePublished - Feb 2019

Bibliographical note

Funding Information:
This research was in part funded by the University of Minnesota Department of Surgery Cancer Fund .

Publisher Copyright:
© 2018

Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.

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