Reconsideration of the lymph node metastasis pattern (N factor) from intrahepatic cholangiocarcinoma using the International Union Against Cancer TNM staging system for primary liver carcinoma

Benefit of radiotherapy for 90 patients with resected intrahepatic cholangiocarcinoma and concurrent lymph node metastases

“…Compared with hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma tends to spread via the lymphatic system; accordingly, the prevalence of lymph node metastases in patients with cholangiocarcinoma is higher (28-60%) (Uenishi et al 2001;Nozaki et al 1998;Zhou et al 2009) than HCC (2.7-5.1%) (Zhou et al 2009;Sun et al 2007). Complete resection is reasonable Wrst-line treatment for aggressive intrahepatic cholangiocarcinoma, and investigations of lymph node dissection to improve survival increase.…”

Current status of intrahepatic cholangiocarcinoma

“…Almost all patients are involved in positive lymph nodes of the hepatoduodenal ligament or along the common hepatic artery, lymph nodes are also found in about half of the patients involving the left lobe of liver [43,44,[53][54][55][56] . Nozaki et al [57] reported that extensive lymph node metastasis was observed in most patients, only 3 (20%) of 15 patients with lymph node metastasis had regional lymph node metastasis. Shimada et al [47] has reported the similar observations, suggesting that lymph node metastasis of ICC is rarely limited to the regional lymph nodes.…”

Impact of adjuvant chemoradiation on survival in patients with resectable cholangiocarcinoma

“…Analogous to gallbladder and pancreatic adenocarcinomas, patients are often diagnosed late in the disease process with both nodal and distant metastases occurring early and often. [1][2][3][4][5][6][7][8] Among the minority of patients whose presentation is amenable to curative resection, local recurrence is the rule not the exception. 1,[9][10][11] While the only curative treatment for CC patients remains surgical resection, post-operative outcomes have shown no significant improvements in the past several years 11 with the current five-year survival rate stagnating at a mere 5% for all CC patients.…”