title: Lymph nodes metastasis is a risk factor for bone metastasis from extrahepatic cholangiocarcinoma.
abstract: OBJECTIVE
  The rate and site of bone metastasis from cholangiocarcinoma as well as the prognosis are unclear. Therefore, we intend to make a comparative review of the background to bone metastasis, examine a high-risk group for bone metastasis and use the data towards the improvement in quality of life.
  
  
  METHODS
  We studied 200 cases of cholangiocarcinoma resected in our division from January 2003 to April 2010.
  
  
  RESULTS
  Bone metastasis was confirmed in four cases (2.0%). The survival period after the diagnosis of bone metastasis ranged from 2.9 months to 21.6 months and the average was 6.7 months. We studied histopathological findings of bone metastasis, lymph node metastasis, lymphatic invasion, blood vessel invasion and perineural invasion (ly, v and pn) and found that all of four bone metastasis cases were positive for lymph node metastasis which was a statistically significant factor affecting bone metastasis.
  
  
  CONCLUSIONS
  Since the number of cases we studied is small, it is difficult to determine whether lymph node metastasis is a risk factor for bone metastasis; however, we think it is necessary to take the probability of bone metastasis into consideration when we provide medical care to patients positive for lymph node metastasis.
authors.affiliation: Integrated Surgery and Oncology, Tohoku Unversity Graduate School of Medicine, Sendai, Japan. y2.katayo@surg1.med.tohoku.ac.jp
authors.forename: Yu
authors.initials: Y
authors.lastname: Katayose
authors.forename: Kei
authors.initials: K
authors.lastname: Nakagawa
authors.forename: Kuniharu
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshida
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hayashi
authors.forename: Masamichi
authors.initials: M
authors.lastname: Mizuma
authors.forename: Hideo
authors.initials: H
authors.lastname: Ohtsuka
authors.forename: Koji
authors.initials: K
authors.lastname: Fukase
authors.forename: Tohru
authors.initials: T
authors.lastname: Onogawa
authors.forename: Fuyuhiko
authors.initials: F
authors.lastname: Motoi
authors.forename: Toshiki
authors.initials: T
authors.lastname: Rikiyama
authors.forename: Shinichi
authors.initials: S
authors.lastname: Egawa
authors.forename: Michiaki
authors.initials: M
authors.lastname: Unno
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D017734:Bile Ducts, Extrahepatic / Q000473:pathology* / Q000601:surgery; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D016009:Chi-Square Distribution; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D005260:Female; D006801:Humans; D007564:Japan; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009361:Neoplasm Invasiveness; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D014057:Tomography, X-Ray Computed