Patterns of regional lymph node involvement in intrahepatic cholangiocarcinoma of the left lobe.
Lymph node involvement is an important prognostic factor in intrahepatic cholangiocarcinoma. Besides the nodes in the hepatoduodenal ligament, recent studies have suggested that the nodes around the cardiac portion of the stomach or along the gastric lesser curvature can be affected when the primary tumor is located in the left hepatic lobe. However, the distribution of metastatic nodes has not been well described in this disease. Thirteen patients with intrahepatic cholangiocarcinoma in the left hepatic lobe were enrolled in this study. Lymphatic mapping was performed by means of both histologic examination and reverse transcriptase-polymerase chain reaction assays. Nodal involvement around the cardiac portion of the stomach or along the lesser gastric curvature (left pathway) was found in 7 (54%) of 13 patients by histologic examination or reverse transcriptase-polymerase chain reaction, whereas positive nodes in the hepatoduodenal ligament (right pathway) were found in 6 (46%) of 13 patients. Two patients (15%) had positive nodes only in the left pathway. Therefore, for a more accurate clinical staging of intrahepatic cholangiocarcinoma in the hepatic left lobe, lymph nodes around the cardiac portion of the stomach and along the lesser gastric curvature should be examined in addition to nodes in the hepatoduodenal ligament.
Department of Surgery and Clinical Oncology, Graduate School of Medicine, Osaka University, Osaka, Japan.
Jiro
J
Okami
Keizo
K
Dono
Masato
M
Sakon
Masanori
M
Tsujie
Nobuyasu
N
Hayashi
Yoshiyuki
Y
Fujiwara
Hiroaki
H
Nagano
Koji
K
Umeshita
Shoji
S
Nakamori
Morito
M
Monden
D000328:Adult; D000368:Aged; D002272:Carcinoembryonic Antigen / Q000096:biosynthesis; D018281:Cholangiocarcinoma / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000503:physiopathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009185:Myelin Proteins; D009363:Neoplasm Proteins; D009367:Neoplasm Staging; D011510:Proteolipids; D020133:Reverse Transcriptase Polymerase Chain Reaction; D060765:Secretoglobins; D014598:Uteroglobin / Q000096:biosynthesis
D002272:Carcinoembryonic Antigen; D009185:Myelin Proteins; D009363:Neoplasm Proteins; D011510:Proteolipids; D060765:Secretoglobins; D014598:Uteroglobin