title: The outcome of liver resection and lymphadenectomy for hilar lymph node involvement in colorectal cancer liver metastases.
abstract: OBJECTIVE
  Hepatic hilar lymph node (HLN) involvement is considered as a poor prognostic factor during liver resection in colorectal liver metastases (CLM). The purpose of this study is to identify the clinical factors that distinguish HLN-positive patients from those who are hilar lymph node negative and to evaluate the frequency of macroscopic involvement of hepatic HLN, to investigate the impact of HLN involvement on survival after resection for CLM with lymphadenectomy and adjuvant chemotherapy.
  
  
  METHODS
  Between January 2000 and August 2012, 73 selected CLM patients underwent liver resections with lymphadenectomy in the Hepatopancreatobiliary Surgery Department I of Beijing Cancer Hospital. Clinical data, surgical outcome, and prognosis after operation of patients with HLN involvement were compared with that of patients without HLN involvement.
  
  
  RESULTS
  Of the 73 patients who underwent liver resections with lymphadenectomy, 12 (16.4 %) patients had HLN involvement identified by pathology. Compared with patients without HLN involvement, the frequency of lymph nodes metastasis for primary tumor was significantly higher in HLN-positive patients (p = 0.023). For CLM patients with and without HLN involvement, 5-year overall survival (OS) was 16.2 and 37.1 %, respectively (p = 0.04). Five-year disease-free survival (DFS) rates were 0 and 32.9 % (p = 0.034). Multivariate analysis showed that involved resected HLN was an independent risk factor for overall survival.
  
  
  CONCLUSIONS
  We should suspect HLN involvement in patients with colorectal cancer liver metastases when they have regional lymph nodes of primary tumor metastasis. Liver resection with HLN dissection might offer a unique curative opportunity for CLM patients with HLN involvement.
authors.affiliation: Hepatopancreatobiliary Surgery Department I, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, No. 52, Fu-Cheng-Lu Street, Beijing, 100142, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.forename: Xiao-Luan
authors.initials: XL
authors.lastname: Yan
authors.forename: Kun
authors.initials: K
authors.lastname: Wang
authors.forename: Quan
authors.initials: Q
authors.lastname: Bao
authors.forename: Yi
authors.initials: Y
authors.lastname: Sun
authors.forename: Bao-Cai
authors.initials: BC
authors.lastname: Xing
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery*; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D016896:Treatment Outcome
references.citation: World J Surg. 1982 Jan;6(1):3-9
references.pmid: 7090393
references.citation: Int J Radiat Oncol Biol Phys. 2010 Nov 1;78(3):729-34
references.pmid: 20171806
references.citation: Dis Colon Rectum. 2007 Apr;50(4):478-88
references.pmid: 17279302
references.citation: Surg Oncol Clin N Am. 2007 Jul;16(3):507-23, viii
references.pmid: 17606191
references.citation: J Am Coll Surg. 2004 Jun;198(6):884-91
references.pmid: 15194069
references.citation: Br J Surg. 2000 Sep;87(9):1142-55
references.pmid: 10971419
references.citation: Br J Surg. 1996 Jul;83(7):942-5
references.pmid: 8813780
references.citation: Abdom Imaging. 2006 Nov-Dec;31(6):632-43
references.pmid: 16897278
references.citation: Ann Surg Oncol. 2002 Jun;9(5):430-8
references.pmid: 12052752
references.citation: Am J Gastroenterol. 2001 Nov;96(11):3178-84
references.pmid: 11721768
references.citation: Ann Surg Oncol. 2012 Jan;19(1):163-8
references.pmid: 21837526
references.citation: J Clin Oncol. 2008 Aug 1;26(22):3672-80
references.pmid: 18669451
references.citation: HPB (Oxford). 2013 Feb;15(2):119-30
references.pmid: 23297723
references.citation: Ann Surg. 2006 Aug;244(2):260-4
references.pmid: 16858189
references.citation: Eur J Surg Oncol. 2007 Apr;33(3):324-8
references.pmid: 17112697
references.citation: Eur Radiol. 2005 Dec;15(12):2469-74
references.pmid: 15999213
references.citation: Dis Colon Rectum. 1999 Oct;42(10):1285-90; discussion 1290-1
references.pmid: 10528765
references.citation: Ann Surg Oncol. 2003 Nov;10(9):1007-11
references.pmid: 14597437
references.citation: J Am Coll Surg. 2007 May;204(5):753-61; discussion 761-3
references.pmid: 17481478
references.citation: Ann Surg. 2009 Sep;250(3):440-8
references.pmid: 19730175
references.citation: J Surg Oncol. 2005 Oct 1;92(1):64-9
references.pmid: 16180230
references.citation: Ann Surg. 1999 Sep;230(3):309-18; discussion 318-21
references.pmid: 10493478
references.citation: Lancet. 1998 Oct 31;352(9138):1413-8
references.pmid: 9807987
references.citation: Cancer. 2002 Feb 15;94(4):921-8
references.pmid: 11920459
references.citation: Ann Surg. 2004 Jun;239(6):818-25; discussion 825-7
references.pmid: 15166961
references.citation: Ann Surg Oncol. 2009 Sep;16(9):2411-21
references.pmid: 19554376
references.citation: J Hepatobiliary Pancreat Surg. 2008;15(6):570-80
references.pmid: 18987925
references.citation: Ann Surg. 2004 Oct;240(4):644-57; discussion 657-8
references.pmid: 15383792
references.citation: Ann Surg Oncol. 2006 Oct;13(10):1271-80
references.pmid: 16955381
references.citation: Gan To Kagaku Ryoho. 2006 Nov;33(12):1834-7
references.pmid: 17212121
references.citation: Cochrane Database Syst Rev. 2009 Oct 07;(4):CD007045
references.pmid: 19821394
references.citation: N Engl J Med. 2004 Jun 3;350(23):2343-51
references.pmid: 15175436
references.citation: J Surg Oncol. 2004 Apr 1;86(1):4-9
references.pmid: 15048673
references.citation: J Clin Pathol. 1995 Mar;48(3):270-2
references.pmid: 7730492
references.citation: Ann Surg. 2004 Aug;240(2):205-13
references.pmid: 15273542
references.citation: Surg Oncol Clin N Am. 2003 Jan;12(1):221-9
references.pmid: 12735140
references.citation: Ann Surg. 2004 Sep;240(3):438-47; discussion 447-50
references.pmid: 15319715
references.citation: Clin Colorectal Cancer. 2010 Oct;9(4):212-8
references.pmid: 20920992
references.citation: Ann Surg. 2004 Dec;240(6):1037-49; discussion 1049-51
references.pmid: 15570209
references.citation: Surg Clin North Am. 1989 Apr;69(2):339-59
references.pmid: 2928902
references.citation: Br J Radiol. 1999 Mar;72(855):246-9
references.pmid: 10396213
references.citation: Cancer. 1985 Apr 1;55(7):1490-4
references.pmid: 3978541
references.citation: Ann Oncol. 2010 May;21 Suppl 5:v70-7
references.pmid: 20555107
references.citation: Ann Surg. 2009 Jun;249(6):879-86
references.pmid: 19474695
references.citation: J Am Coll Surg. 1999 Sep;189(3):291-9
references.pmid: 10472930
references.citation: Ann Surg. 2004 Feb;239(2):202-9
references.pmid: 14745328
references.citation: J Hepatobiliary Pancreat Surg. 1999;6(1):16-22
references.pmid: 10436233
references.citation: J Clin Oncol. 2005 Aug 1;23(22):4888-96
references.pmid: 16009951
references.citation: Ann Surg. 1987 Dec;206(6):685-93
references.pmid: 2961314
references.citation: Br J Surg. 2010 Sep;97(9):1407-15
references.pmid: 20564305
references.citation: Ann Surg. 2004 Nov;240(5):858-65
references.pmid: 15492569
references.citation: Surg Oncol. 2007 Jul;16(1):65-70
references.pmid: 17521906