title: Indications for surgical treatment of intrahepatic cholangiocarcinoma with lymph node metastases.
abstract: OBJECTIVE
  The postoperative outcome of patients who have intrahepatic cholangiocarcinoma with lymph node metastases is extremely poor, and the indications for surgery for such patients have yet to be clearly established.
  
  
  METHODS
  The demographic and clinical characteristics of 133 patients who underwent lymph node dissection during hepatic resection of intrahepatic cholangiocarcinoma were retrospectively analyzed.
  
  
  RESULTS
  Multivariate analysis identified three independent prognostic factors: intrahepatic metastasis, nodal involvement, and tumor at the margin of resection. Of the patients with tumor-free surgical margins, none of the 24 patients who had both lymph node metastases and intrahepatic metastases survived for 3 years. In contrast, the survival rates for the 23 patients who had lymph node metastases associated with a solitary tumor were 35% at 3 years and 26% at 5 years.
  
  
  CONCLUSIONS
  Surgery alone cannot prolong survival when both lymph node metastases and intrahepatic metastases are present, while surgery may provide a chance for long-term survival in some patients who have lymph node metastases associated with a solitary intrahepatic cholangiocarcinoma tumor.
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Uenishi
authors.forename: Shoji
authors.initials: S
authors.lastname: Kubo
authors.forename: Osamu
authors.initials: O
authors.lastname: Yamazaki
authors.forename: Terumasa
authors.initials: T
authors.lastname: Yamada
authors.forename: Yo
authors.initials: Y
authors.lastname: Sasaki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
authors.forename: Morito
authors.initials: M
authors.lastname: Monden
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies