ArticleAnnals of surgical oncology2015
Lymph Node Micrometastases are Associated with Worse Survival in Patients with Otherwise Node-Negative Hilar Cholangiocarcinoma.
Article in Annals of surgical oncology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Routine Lymph Node Dissection in the Surgical Treatment of Primary Liver Tumors: a Systematic Review and Meta-Analysis.Journal of gastrointestinal cancer · 2026Pooled it
- Intraoperative Paraaortic Lymph Node Sampling to Guide Surgical Decision-Making in Perihilar Cholangiocarcinoma.Annals of surgical oncology · 2026Article
- Surgical management of intrahepatic cholangiocarcinoma and combined hepatocellular-cholangiocarcinoma: a narrative review of principles, technical nuances, and emerging strategies.Journal of liver cancer · 2026Review
- Prognostic impact of individual resection and dissection margins in resected perihilar cholangiocarcinoma: retrospective study.BJS open · 2025Article
- "Five steps four quadrants" modularizedWorld journal of gastrointestinal surgery · 2024Article
- Surgical management of hilar cholangiocarcinoma: Controversies and recommendations.Annals of hepato-biliary-pancreatic surgery · 2023Review
- Extended Lymphadenectomy Versus Regional Lymphadenectomy in Resectable Hilar Cholangiocarcinoma.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020Article
- Extended lymphadenectomy in hilar cholangiocarcinoma: What it will bring?World journal of gastroenterology · 2020Review
- Prognostic Nomogram That Predicts Overall Survival of Patients with Distal Cholangiocarcinoma After Pancreatoduodenectomy.Cancer management and research · 2020Article
- Cinobufagin inhibits tumor growth by inducing apoptosis through Notch signaling pathways in human cholangiocarcinoma.Translational cancer research · 2019Article
- Article
- Prognostic value of lymph nodes count on survival of patients with distal cholangiocarcinomas.World journal of gastroenterology · 2018Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLymph node metastases on routine histology are a strong negative predictor for survival after resection of hilar cholangiocarcinoma. Additional immunohistochemistry can detect lymph node micrometastases in patients who are otherwise node negative, but the prognostic value is unsure. The objective of this study was to assess the effect on survival of immunohistochemically detected lymph node micrometastases in patients with node-negative (pN0) hilar cholangiocarcinoma on routine histology.
methodsBetween 1990 and 2010, a total of 146 patients underwent curative-intent resection of hilar cholangiocarcinoma with regional lymphadenectomy at two university medical centers in the Netherlands. Ninety-one patients (62 %) without lymph node metastases at routine histology were included. Micrometastases were identified by multiple sectioning of all lymph nodes and additional immunostaining with an antibody against cytokeratin 19 (K19). The association with overall survival was assessed in univariable and multivariable analysis. Median follow-up was 48 months.
resultsMicrometastases were identified in 16 (5 %) of 324 lymph nodes, corresponding to 11 (12 %) of 91 patients. There were no differences in clinical variables between K19 lymph node-positive and -negative patients. Five-year survival rates in patients with lymph node micrometastases were significantly lower compared to patients without micrometastases (27 vs. 54 %, P = 0.01). Multivariable analysis confirmed micrometastases as an independent prognostic factor for survival (adjusted Hazard ratio 2.4, P = 0.02).
conclusionsLymph node micrometastases are associated with worse survival after resection of hilar cholangiocarcinoma. Immunohistochemical detection of lymph node micrometastases leads to better staging of patients who were initially diagnosed with node-negative (pN0) hilar cholangiocarcinoma on routine histology.
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