Incidence and prognostic values of lymph node metastasis in operable hepatocellular carcinoma and evaluation of routine complete lymphadenectomy.
BACKGROUND
To study lymph node metastasis (LNM) and prognosis in patients with operable hepatocellular carcinoma (HCC) as well as the value of routine complete lymphadenectomy. Few studies have been reported on LNM in patients with operable HCC.


METHODS
Lymph node enlargement of 968 patients with operable HCC was carefully explored and LNM was diagnosed by typical intraoperative findings or pathology.


RESULTS
Forty-nine (5.1%) patients had LNM, which was associated with advanced tumor properties. The 1-, 3-, and 5-year overall survival in patients with LNM was poorer than those without LNM (62.0%, 31.0%, and 26.0% vs. 81.0%, 62.0%, and 47.0%, P = 0.000). The 1-, 3-, and 5-year overall survival in patients who received complete lymphadenectomy (n = 26) was poorer than those without LNM (68.0%, 31.0%, and 31.0% vs. 81.0%, 62.0%, and 47.0%, P = 0.017), and was not better than patients who received chemotherapy or radiotherapy (P = 0.944).


CONCLUSIONS
The incidence of LNM in operable HCC patients was low, and patients with LNM had a poorer prognosis. LNM status determined the disease-free survival but not the overall survival of HCC. The complete lymphadenectomy did not improve overall survival, as compared with chemotherapy or radiotherapy.
Sun
Hui-Chuan
HC
Live Cancer Institute and Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China. sunhc@zshospital.com
Zhuang
Peng-Yuan
PY
Qin
Lun-Xiu
LX
Ye
Qing-Hai
QH
Wang
Lu
L
Ren
Ning
N
Zhang
Ju-Bo
JB
Qian
Yong-Bing
YB
Lu
Lu
L
Fan
Jia
J
Tang
Zhao-You
ZY
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000556:secondary*; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology*; D008197:Lymph Node Excision / Q000401:mortality*; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D015996:Survival Rate