The ratio between metastatic and examined lymph nodes is an independent prognostic factor for patients with resectable middle and distal bile duct carcinoma.
BACKGROUND
The lymph node ratio, defined as the ratio between the number of lymph node metastasis and the total number of lymph nodes examined, has been reported to be an important prognostic factor in other gastrointestinal carcinomas except middle and distal bile duct carcinomas.


METHODS
Between 1991 and 2004, 62 consecutive patients who underwent surgery for middle and distal bile duct carcinoma were retrospectively analyzed concerning prognostic factors.


RESULTS
The median number of lymph nodes examined was 12 (range 5 to 38). The overall 5-year survival rates of patients with lymph node ratio of 0, lymph node ratio of 0 to .2, and lymph node ratio >.2 were 62%, 41%, and 0%, respectively. A multivariate analysis revealed that a lymph node ratio >.2 and perineural invasion were independent predictive factors for survival.


CONCLUSIONS
Lymph node ratio >.2 is an important factor to predict survival after resected middle and distal bile duct carcinoma.
Kawai
Manabu
M
Second Department of Surgery, Wakayama Medical University, School of Medicine, 811-1 Kimiidera, Wakayama 641-8510, Japan.
Tani
Masaji
M
Kobayashi
Yasuhito
Y
Tsuji
Takeshi
T
Tabuse
Katsuyoshi
K
Horiuchi
Tetsuya
T
Oka
Masami
M
Yamaguchi
Kazuya
K
Sakata
Yoshifumi
Y
Shimomura
Tomoo
T
Yamaue
Hiroki
H
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D001365:Axilla; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures / Q000379:methods; D002277:Carcinoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D021441:Carcinoma, Pancreatic Ductal / Q000556:secondary / Q000601:surgery; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate