title: Significance of hepatic pedicle lymph node involvement in patients with colorectal liver metastases: a prospective study.
abstract: BACKGROUND
  We investigated whether hepatic pedicle lymph node (HP-LN) involvement is a more significant prognostic factor and whether HP-LN dissection could be efficient in patients with positive HP-LN involvement.
  
  
  METHODS
  From 1988 to 1998, HP-LN dissection was prospectively performed in 160 patients undergoing hepatectomy for colorectal liver metastases. Survival of patients with HP-LN involvement limited to the hepatoduodenal ligament and retropancreatic portion (area 1) was compared with that of patients with HP-LN involvement spreading over the common hepatic artery and celiac axis (area 2).
  
  
  RESULTS
  HP-LN involvement was detected in 17 patients. The survival rate was significantly lower in patients with HP-LN involvement. HP-LN involvement was the most significant prognostic factor. Survival was significantly higher in patients with HP-LN involvement limited to area 1 than in those with HP-LN involvement spreading over area 2.
  
  
  CONCLUSIONS
  HP-LN involvement was the most significant prognostic indicator in patients with colorectal liver metastases. Positive LNs of area 1 should no longer be considered an absolute contraindication to liver resection, but in case of area 2 lymph node involvement, liver resection does not seem justified.
authors.affiliation: Centre de Chirurgie Viscérale et de Transplantation, Hôpital de Hautepierre, Avenue Molière, 67098 Strasbourg Cedex, France. daniel.jaeck@chru-strasbourg.fr
authors.forename: Daniel
authors.initials: D
authors.lastname: Jaeck
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakano
authors.forename: Philippe
authors.initials: P
authors.lastname: Bachellier
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Inoue
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Weber
authors.forename: Elie
authors.initials: E
authors.lastname: Oussoultzoglou
authors.forename: Philippe
authors.initials: P
authors.lastname: Wolf
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Chenard-Neu
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis