TY - JOUR
T1 - Prognostic impact of the number of metastatic lymph nodes in distal bile duct cancer
T2 - An analysis of Japanese registration cases by the study group for biliary surgery of the Japanese Society of Hepato-Biliary-Pancreatic Surgery
AU - Ishihara, Shin
AU - Horiguchi, Akihiko
AU - Endo, Itaru
AU - Wakaki, Toshifumi
AU - Hirano, Satoshi
AU - Yamaue, Hiroki
AU - Yamamoto, Masakazu
N1 - Funding Information:
This registration was carried out as part of a project of the Japanese Society of Hepato-Biliary-Pancreatic Surgery (JSHBPS). The authors thank the registration institutions and members of the JSHBPS. The authors are grateful to Professor Takuma Ishihara (Gifu University) and Professor Ayumi Shintani (Osaka City University) for their contribution to the statistical analysis.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Background: Lymph node metastasis is an important prognostic factor for distal bile duct cancer. The number of lymph node metastases was adopted for nodal classification. However, different cutoff values have been proposed, ranging from two to five. Methods: A total of 1748 cases who underwent curative surgery with pancreatoduodenectomy for distal bile duct cancer registered in the nationwide biliary tract cancer registry in Japan from 2008 to 2013 were included. Univariate Cox regression was performed to assess the effect of prognostic lymph node metastasis counts on mortality and to determine cutoff values. Results: The overall survival rate after resection was 47.4% at 5 years. Univariate and multivariate analysis found prognostic factors to include lymph node metastasis. The cutoff point was set to two lymph node metastases using the Cox model. There were significant differences in pairwise comparisons between three groups by the number of metastatic lymph node (P <.001 for 0 vs 1-2 and P =.003 for 1–2 vs ≥3). Conclusion: Our data suggest lymph node classification as N0 (patients without lymph node metastases), N1 (metastasis in 1–2 regional lymph nodes), and N2 (metastases in ≥3 regional lymph nodes).
AB - Background: Lymph node metastasis is an important prognostic factor for distal bile duct cancer. The number of lymph node metastases was adopted for nodal classification. However, different cutoff values have been proposed, ranging from two to five. Methods: A total of 1748 cases who underwent curative surgery with pancreatoduodenectomy for distal bile duct cancer registered in the nationwide biliary tract cancer registry in Japan from 2008 to 2013 were included. Univariate Cox regression was performed to assess the effect of prognostic lymph node metastasis counts on mortality and to determine cutoff values. Results: The overall survival rate after resection was 47.4% at 5 years. Univariate and multivariate analysis found prognostic factors to include lymph node metastasis. The cutoff point was set to two lymph node metastases using the Cox model. There were significant differences in pairwise comparisons between three groups by the number of metastatic lymph node (P <.001 for 0 vs 1-2 and P =.003 for 1–2 vs ≥3). Conclusion: Our data suggest lymph node classification as N0 (patients without lymph node metastases), N1 (metastasis in 1–2 regional lymph nodes), and N2 (metastases in ≥3 regional lymph nodes).
UR - http://www.scopus.com/inward/record.url?scp=85083055879&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85083055879&partnerID=8YFLogxK
U2 - 10.1002/jhbp.730
DO - 10.1002/jhbp.730
M3 - Article
C2 - 32128955
AN - SCOPUS:85083055879
VL - 27
SP - 396
EP - 401
JO - Journal of Hepato-Biliary-Pancreatic Sciences
JF - Journal of Hepato-Biliary-Pancreatic Sciences
SN - 1868-6974
IS - 7
ER -