title: Correlation between metastatic lymph node ratio and prognosis in patients with extrahepatic cholangiocarcinoma.
abstract: OBJECTIVE
  To investigate the prognostic value of metastatic lymph node ratio (MLNR) in extrahepatic cholangiocarcinoma (ECC) patients undergoing radical resection.
  
  
  METHODS
  Seventy-eight patients with ECC were enrolled. Associations between various clinicopathologic factors and prognosis were investigated by Kaplan-Meier analyses. The Cox proportional-hazards model was used for multivariate survival analysis.
  
  
  RESULTS
  The overall three- and five-year survival rates were 47.26% and 23.99%, respectively. MLNR of 0, 0-0.2, 0.2-0.5, and > 0.5 corresponded to five-year survival rates of 28.59%, 21.60%, 18.84%, and 10.03%, respectively. Univariate analysis showed that degree of tumor differentiation, lymph node metastasis, MLNR, tumor-node-metastasis (TNM) stage, and margin status were closely associated with postoperative survival in ECC patients (P < 0.05). Multivariate analysis showed that MLNR and TNM stage were independent prognostic factors after pancreaticoduodenectomy (HR = 2.13, 95%CI: 1.45-3.11; P < 0.01; and HR = 1.97, 95%CI: 1.17-3.31; P = 0.01, respectively). The median survival time for MLNR > 0.5, 0.2-0.5, 0-0.2, and 0 was 15 mo, 24 mo, 23 mo, and 35.5 mo, respectively. There were statistical differences in survival time between patients with different MLNR (χ(2) = 15.38; P < 0.01).
  
  
  CONCLUSIONS
  MLNR is an independent prognostic factor for ECC patients after radical resection and is useful for predicting postoperative survival.
authors.affiliation: Jian-Wei Zhang, Yun-Mian Chu, Zhong-Min Lan, Xiao-Long Tang, Ying-Tai Chen, Cheng-Feng Wang, Xu Che, Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
authors.forename: Jian-Wei
authors.initials: JW
authors.lastname: Zhang
authors.affiliation: Jian-Wei Zhang, Yun-Mian Chu, Zhong-Min Lan, Xiao-Long Tang, Ying-Tai Chen, Cheng-Feng Wang, Xu Che, Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
authors.forename: Yun-Mian
authors.initials: YM
authors.lastname: Chu
authors.affiliation: Jian-Wei Zhang, Yun-Mian Chu, Zhong-Min Lan, Xiao-Long Tang, Ying-Tai Chen, Cheng-Feng Wang, Xu Che, Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
authors.forename: Zhong-Min
authors.initials: ZM
authors.lastname: Lan
authors.affiliation: Jian-Wei Zhang, Yun-Mian Chu, Zhong-Min Lan, Xiao-Long Tang, Ying-Tai Chen, Cheng-Feng Wang, Xu Che, Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
authors.forename: Xiao-Long
authors.initials: XL
authors.lastname: Tang
authors.affiliation: Jian-Wei Zhang, Yun-Mian Chu, Zhong-Min Lan, Xiao-Long Tang, Ying-Tai Chen, Cheng-Feng Wang, Xu Che, Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
authors.forename: Ying-Tai
authors.initials: YT
authors.lastname: Chen
authors.affiliation: Jian-Wei Zhang, Yun-Mian Chu, Zhong-Min Lan, Xiao-Long Tang, Ying-Tai Chen, Cheng-Feng Wang, Xu Che, Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
authors.forename: Cheng-Feng
authors.initials: CF
authors.lastname: Wang
authors.affiliation: Jian-Wei Zhang, Yun-Mian Chu, Zhong-Min Lan, Xiao-Long Tang, Ying-Tai Chen, Cheng-Feng Wang, Xu Che, Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Che
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D002454:Cell Differentiation; D016009:Chi-Square Distribution; D018281:Cholangiocarcinoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016577:Pancreaticoduodenectomy; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cholangiocarcinoma; Metastatic lymph node; Prognosis; Surgery