Publicação
Therapeutic Index Associated with Lymphadenectomy Among Patients with Intrahepatic Cholangiocarcinoma: Which Patients Benefit the Most from Nodal Evaluation?
| Resumo: | Background: Although lymph node metastasis (LNM) is an important prognostic indicator for patients with intrahepatic cholangiocarcinoma (ICC), the benefit and indication for lymphadenectomy remain unclear. Methods: Patients diagnosed with ICC between 1990 and 2016 were identified in the international multi-institutional dataset. To determine the survival benefit from lymphadenectomy, the therapeutic index was calculated by multiplying the frequency of LNM in a particular group of patients by the 3-year cancer-specific survival (CSS) rate of patients with LNM in that subgroup. Results: Among 471 patients who met the inclusion criteria, approximately half had LNM (n = 205, 43.5%). The median number of resected and metastatic LNs were 4 [interquartile range (IQR) 2-8] and 0 (IQR 0-1), respectively. Three-year CSS in the entire cohort was 29.9%, reflecting a therapeutic index value of 13.0. The therapeutic index was lower among patients with major vascular invasion (5.4), preoperative carcinoembryonic antigen (CEA) > 5.0 (8.2), and LNM in areas other than the hepatoduodenal ligament (5.2). Of note, a therapeutic index difference of more than 10 points was noted only when examining the number of LNs harvested [1-2 (4.1) vs. 3-6 (16.1) vs. ≥ 7 (17.8)]. Conclusion: The survival benefit derived from lymphadenectomy was poor among patients with major vascular invasion, CEA > 5.0, and LNM in areas other than the hepatoduodenal ligament. Resection of three or more LNs was associated with the highest therapeutic value among patients with LNM. |
|---|---|
| Autores principais: | Sahara, K |
| Outros Autores: | Tsilimigras, D; Merath, K; Bagante, F; Guglielmi, A; Aldrighetti, L; Weiss, M; Bauer, T; Alexandrescu, S; Poultsides, G; Maithel, S; Pinto Marques, H; Martel, G; Pulitano, C; Shen, F; Soubrane, O; Koerkamp, B; Matsuyama, R; Endo, I; Pawlik, T |
| Assunto: | HCC CIR Aged Female Bile Duct Neoplasms / secondary Bile Duct Neoplasms / surgery* Cholangiocarcinoma / pathology Cholangiocarcinoma / surgery* Male Follow-Up Studies Hepatectomy / mortality* Humans Lymph Node Excision / mortality* Lymph Nodes / pathology* Midlle Aged Lymphatic Metastasis Neoplasm Staging Prognosis Survival Rate Therapeutic Index* |
| Ano: | 2019 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Centro Hospitalar de Lisboa Central, EPE (CHLC) |
| Idioma: | inglês |
| Origem: | Repositório do Centro Hospitalar de Lisboa Central, EPE |
| _version_ | 1868412177468096512 |
|---|---|
| author | Sahara, K |
| author2 | Tsilimigras, D Merath, K Bagante, F Guglielmi, A Aldrighetti, L Weiss, M Bauer, T Alexandrescu, S Poultsides, G Maithel, S Pinto Marques, H Martel, G Pulitano, C Shen, F Soubrane, O Koerkamp, B Matsuyama, R Endo, I Pawlik, T |
| author2_role | author author author author author author author author author author author author author author author author author author author |
| author_facet | Sahara, K Tsilimigras, D Merath, K Bagante, F Guglielmi, A Aldrighetti, L Weiss, M Bauer, T Alexandrescu, S Poultsides, G Maithel, S Pinto Marques, H Martel, G Pulitano, C Shen, F Soubrane, O Koerkamp, B Matsuyama, R Endo, I Pawlik, T |
| author_role | author |
| contributor_name_str_mv | Repositório da Unidade Local de Saúde São José |
| country_str | PT |
| creators_json_txt | [{\"Person.name\":\"Sahara, K\"},{\"Person.name\":\"Tsilimigras, D\"},{\"Person.name\":\"Merath, K\"},{\"Person.name\":\"Bagante, F\"},{\"Person.name\":\"Guglielmi, A\"},{\"Person.name\":\"Aldrighetti, L\"},{\"Person.name\":\"Weiss, M\"},{\"Person.name\":\"Bauer, T\"},{\"Person.name\":\"Alexandrescu, S\"},{\"Person.name\":\"Poultsides, G\"},{\"Person.name\":\"Maithel, S\"},{\"Person.name\":\"Pinto Marques, H\"},{\"Person.name\":\"Martel, G\"},{\"Person.name\":\"Pulitano, C\"},{\"Person.name\":\"Shen, F\"},{\"Person.name\":\"Soubrane, O\"},{\"Person.name\":\"Koerkamp, B\"},{\"Person.name\":\"Matsuyama, R\"},{\"Person.name\":\"Endo, I\"},{\"Person.name\":\"Pawlik, T\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | Repositório da Unidade Local de Saúde São José |
| datacite.creators.creator.creatorName.fl_str_mv | Sahara, K Tsilimigras, D Merath, K Bagante, F Guglielmi, A Aldrighetti, L Weiss, M Bauer, T Alexandrescu, S Poultsides, G Maithel, S Pinto Marques, H Martel, G Pulitano, C Shen, F Soubrane, O Koerkamp, B Matsuyama, R Endo, I Pawlik, T |
| datacite.date.Accepted.fl_str_mv | 2019-01-01T00:00:00Z |
| datacite.date.available.fl_str_mv | 2021-10-08T14:38:31Z |
| datacite.date.embargoed.fl_str_mv | 2021-10-08T14:38:31Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | HCC CIR Aged Female Bile Duct Neoplasms / secondary Bile Duct Neoplasms / surgery* Cholangiocarcinoma / pathology Cholangiocarcinoma / surgery* Male Follow-Up Studies Hepatectomy / mortality* Humans Lymph Node Excision / mortality* Lymph Nodes / pathology* Midlle Aged Lymphatic Metastasis Neoplasm Staging Prognosis Survival Rate Therapeutic Index* |
| datacite.titles.title.fl_str_mv | Therapeutic Index Associated with Lymphadenectomy Among Patients with Intrahepatic Cholangiocarcinoma: Which Patients Benefit the Most from Nodal Evaluation? |
| dc.contributor.none.fl_str_mv | Repositório da Unidade Local de Saúde São José |
| dc.creator.none.fl_str_mv | Sahara, K Tsilimigras, D Merath, K Bagante, F Guglielmi, A Aldrighetti, L Weiss, M Bauer, T Alexandrescu, S Poultsides, G Maithel, S Pinto Marques, H Martel, G Pulitano, C Shen, F Soubrane, O Koerkamp, B Matsuyama, R Endo, I Pawlik, T |
| dc.date.Accepted.fl_str_mv | 2019-01-01T00:00:00Z |
| dc.date.available.fl_str_mv | 2021-10-08T14:38:31Z |
| dc.date.embargoed.fl_str_mv | 2021-10-08T14:38:31Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10400.17/3871 |
| dc.language.none.fl_str_mv | eng |
| dc.publisher.none.fl_str_mv | Springer |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.subject.none.fl_str_mv | HCC CIR Aged Female Bile Duct Neoplasms / secondary Bile Duct Neoplasms / surgery* Cholangiocarcinoma / pathology Cholangiocarcinoma / surgery* Male Follow-Up Studies Hepatectomy / mortality* Humans Lymph Node Excision / mortality* Lymph Nodes / pathology* Midlle Aged Lymphatic Metastasis Neoplasm Staging Prognosis Survival Rate Therapeutic Index* |
| dc.title.fl_str_mv | Therapeutic Index Associated with Lymphadenectomy Among Patients with Intrahepatic Cholangiocarcinoma: Which Patients Benefit the Most from Nodal Evaluation? |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_6501 |
| description | Background: Although lymph node metastasis (LNM) is an important prognostic indicator for patients with intrahepatic cholangiocarcinoma (ICC), the benefit and indication for lymphadenectomy remain unclear. Methods: Patients diagnosed with ICC between 1990 and 2016 were identified in the international multi-institutional dataset. To determine the survival benefit from lymphadenectomy, the therapeutic index was calculated by multiplying the frequency of LNM in a particular group of patients by the 3-year cancer-specific survival (CSS) rate of patients with LNM in that subgroup. Results: Among 471 patients who met the inclusion criteria, approximately half had LNM (n = 205, 43.5%). The median number of resected and metastatic LNs were 4 [interquartile range (IQR) 2-8] and 0 (IQR 0-1), respectively. Three-year CSS in the entire cohort was 29.9%, reflecting a therapeutic index value of 13.0. The therapeutic index was lower among patients with major vascular invasion (5.4), preoperative carcinoembryonic antigen (CEA) > 5.0 (8.2), and LNM in areas other than the hepatoduodenal ligament (5.2). Of note, a therapeutic index difference of more than 10 points was noted only when examining the number of LNs harvested [1-2 (4.1) vs. 3-6 (16.1) vs. ≥ 7 (17.8)]. Conclusion: The survival benefit derived from lymphadenectomy was poor among patients with major vascular invasion, CEA > 5.0, and LNM in areas other than the hepatoduodenal ligament. Resection of three or more LNs was associated with the highest therapeutic value among patients with LNM. |
| dirty | 0 |
| eu_rights_str_mv | openAccess |
| format | article |
| fulltext.url.fl_str_mv | https://repositorio.chlc.pt/bitstreams/0d5cbcd4-3537-4235-a010-614009c7a81a/download |
| id | rchlc_55f44e2dfc8d5b8c1940099b1edee157 |
| identifier.url.fl_str_mv | http://hdl.handle.net/10400.17/3871 |
| instacron_str | chlc |
| institution | Centro Hospitalar de Lisboa Central, EPE (CHLC) |
| instname_str | Centro Hospitalar de Lisboa Central, EPE (CHLC) |
| language | eng |
| network_acronym_str | rchlc |
| network_name_str | Repositório do Centro Hospitalar de Lisboa Central, EPE |
| oai_identifier_str | oai:repositorio.chlc.pt:10400.17/3871 |
| organization_str_mv | urn:organizationAcronym:chlc |
| person_str_mv | Sahara, K Tsilimigras, D Merath, K Bagante, F Guglielmi, A Aldrighetti, L Weiss, M Bauer, T Alexandrescu, S Poultsides, G Maithel, S Pinto Marques, H Martel, G Pulitano, C Shen, F Soubrane, O Koerkamp, B Matsuyama, R Endo, I Pawlik, T |
| publishDate | 2019 |
| publisher.none.fl_str_mv | Springer |
| reponame_str | Repositório do Centro Hospitalar de Lisboa Central, EPE |
| repository_id_str | urn:repositoryAcronym:rchlc |
| service_str_mv | urn:repositoryAcronym:rchlc |
| spelling | engSpringerpt_PTBackground: Although lymph node metastasis (LNM) is an important prognostic indicator for patients with intrahepatic cholangiocarcinoma (ICC), the benefit and indication for lymphadenectomy remain unclear. Methods: Patients diagnosed with ICC between 1990 and 2016 were identified in the international multi-institutional dataset. To determine the survival benefit from lymphadenectomy, the therapeutic index was calculated by multiplying the frequency of LNM in a particular group of patients by the 3-year cancer-specific survival (CSS) rate of patients with LNM in that subgroup. Results: Among 471 patients who met the inclusion criteria, approximately half had LNM (n = 205, 43.5%). The median number of resected and metastatic LNs were 4 [interquartile range (IQR) 2-8] and 0 (IQR 0-1), respectively. Three-year CSS in the entire cohort was 29.9%, reflecting a therapeutic index value of 13.0. The therapeutic index was lower among patients with major vascular invasion (5.4), preoperative carcinoembryonic antigen (CEA) > 5.0 (8.2), and LNM in areas other than the hepatoduodenal ligament (5.2). Of note, a therapeutic index difference of more than 10 points was noted only when examining the number of LNs harvested [1-2 (4.1) vs. 3-6 (16.1) vs. ≥ 7 (17.8)]. Conclusion: The survival benefit derived from lymphadenectomy was poor among patients with major vascular invasion, CEA > 5.0, and LNM in areas other than the hepatoduodenal ligament. Resection of three or more LNs was associated with the highest therapeutic value among patients with LNM.application/pdfpt_PTTherapeutic Index Associated with Lymphadenectomy Among Patients with Intrahepatic Cholangiocarcinoma: Which Patients Benefit the Most from Nodal Evaluation?Sahara, KTsilimigras, DMerath, KBagante, FGuglielmi, AAldrighetti, LWeiss, MBauer, TAlexandrescu, SPoultsides, GMaithel, SPinto Marques, HMartel, GPulitano, CShen, FSoubrane, OKoerkamp, BMatsuyama, REndo, IPawlik, THostingInstitutionOrganizationalRepositório da Unidade Local de Saúde São Josée-mailmailto:repositorio@ulssjose.min-saude.ptrepositorio@ulssjose.min-saude.ptDOIIsPartOf10.1245/s10434-019-07483-9.2021-10-08T14:38:31Z20192019-01-01T00:00:00ZHandlehttp://hdl.handle.net/10400.17/3871http://purl.org/coar/access_right/c_abf2open accessHCC CIRAgedFemaleBile Duct Neoplasms / secondaryBile Duct Neoplasms / surgery*Cholangiocarcinoma / pathologyCholangiocarcinoma / surgery*MaleFollow-Up StudiesHepatectomy / mortality*HumansLymph Node Excision / mortality*Lymph Nodes / pathology*Midlle AgedLymphatic MetastasisNeoplasm StagingPrognosisSurvival RateTherapeutic Index*323125 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal articlehttp://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://repositorio.chlc.pt/bitstreams/0d5cbcd4-3537-4235-a010-614009c7a81a/downloadAnnals of Surgical Oncology2629592968 |
| spellingShingle | Therapeutic Index Associated with Lymphadenectomy Among Patients with Intrahepatic Cholangiocarcinoma: Which Patients Benefit the Most from Nodal Evaluation? Sahara, K HCC CIR Aged Female Bile Duct Neoplasms / secondary Bile Duct Neoplasms / surgery* Cholangiocarcinoma / pathology Cholangiocarcinoma / surgery* Male Follow-Up Studies Hepatectomy / mortality* Humans Lymph Node Excision / mortality* Lymph Nodes / pathology* Midlle Aged Lymphatic Metastasis Neoplasm Staging Prognosis Survival Rate Therapeutic Index* |
| status | SINGLETON |
| subject.fl_str_mv | HCC CIR Aged Female Bile Duct Neoplasms / secondary Bile Duct Neoplasms / surgery* Cholangiocarcinoma / pathology Cholangiocarcinoma / surgery* Male Follow-Up Studies Hepatectomy / mortality* Humans Lymph Node Excision / mortality* Lymph Nodes / pathology* Midlle Aged Lymphatic Metastasis Neoplasm Staging Prognosis Survival Rate Therapeutic Index* |
| title | Therapeutic Index Associated with Lymphadenectomy Among Patients with Intrahepatic Cholangiocarcinoma: Which Patients Benefit the Most from Nodal Evaluation? |
| title_full | Therapeutic Index Associated with Lymphadenectomy Among Patients with Intrahepatic Cholangiocarcinoma: Which Patients Benefit the Most from Nodal Evaluation? |
| title_fullStr | Therapeutic Index Associated with Lymphadenectomy Among Patients with Intrahepatic Cholangiocarcinoma: Which Patients Benefit the Most from Nodal Evaluation? |
| title_full_unstemmed | Therapeutic Index Associated with Lymphadenectomy Among Patients with Intrahepatic Cholangiocarcinoma: Which Patients Benefit the Most from Nodal Evaluation? |
| title_short | Therapeutic Index Associated with Lymphadenectomy Among Patients with Intrahepatic Cholangiocarcinoma: Which Patients Benefit the Most from Nodal Evaluation? |
| title_sort | Therapeutic Index Associated with Lymphadenectomy Among Patients with Intrahepatic Cholangiocarcinoma: Which Patients Benefit the Most from Nodal Evaluation? |
| topic | HCC CIR Aged Female Bile Duct Neoplasms / secondary Bile Duct Neoplasms / surgery* Cholangiocarcinoma / pathology Cholangiocarcinoma / surgery* Male Follow-Up Studies Hepatectomy / mortality* Humans Lymph Node Excision / mortality* Lymph Nodes / pathology* Midlle Aged Lymphatic Metastasis Neoplasm Staging Prognosis Survival Rate Therapeutic Index* |
| topic_facet | HCC CIR Aged Female Bile Duct Neoplasms / secondary Bile Duct Neoplasms / surgery* Cholangiocarcinoma / pathology Cholangiocarcinoma / surgery* Male Follow-Up Studies Hepatectomy / mortality* Humans Lymph Node Excision / mortality* Lymph Nodes / pathology* Midlle Aged Lymphatic Metastasis Neoplasm Staging Prognosis Survival Rate Therapeutic Index* |
| url | http://hdl.handle.net/10400.17/3871 |
| visible | 1 |