title: The ratio between metastatic and examined lymph nodes is an independent prognostic factor for patients with resectable middle and distal bile duct carcinoma.
abstract: 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.
authors: Second Department of Surgery, Wakayama Medical University, School of Medicine, 811-1 Kimiidera, Wakayama 641-8510, Japan.
authors: Manabu
authors: M
authors: Kawai
authors: Masaji
authors: M
authors: Tani
authors: Yasuhito
authors: Y
authors: Kobayashi
authors: Takeshi
authors: T
authors: Tsuji
authors: Katsuyoshi
authors: K
authors: Tabuse
authors: Tetsuya
authors: T
authors: Horiuchi
authors: Masami
authors: M
authors: Oka
authors: Kazuya
authors: K
authors: Yamaguchi
authors: Yoshifumi
authors: Y
authors: Sakata
authors: Tomoo
authors: T
authors: Shimomura
authors: Hiroki
authors: H
authors: Yamaue
mesh_terms: 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