Abstract：
BACKGROUND: The benefits of lymph node (LN) dissection at each station have not previously been fully investigated in perihilar cholangiocarcinoma (PHCC) and distal cholangiocarcinoma (DCC).
METHODS: The efficacy index (EI) was calculated in patients who underwent surgery for PHCC (n = 134) and DCC (n = 135) by multiplying the frequency of metastasis to the LN station and the 5-year overall survival (OS) rate of patients with metastasis to that station.
RESULTS: In PHCC, the frequency of metastasis, 5-year OS rates, and the EI in para-aortic LNs (4.7%, 0%, and 0, respectively) and posterior pancreaticoduodenal LNs (8.1%, 0%, and 0, respectively) were lower than those in hepatoduodenal ligament LNs (30.1%, 24.1%, and 7.25, respectively) and LNs along the common hepatic artery (CHA) (16.2%, 15.0%, and 2.43, respectively). In DCC, these values were lower in LNs along the CHA (6.4%, 0%, and 0, respectively) than in the posterior pancreaticoduodenal LNs (31.2%, 34.5%, and 10.8, respectively), the hepatoduodenal ligament LNs (14.8%, 15.2%, and 2.25, respectively), and para-aortic (4.0%, 25.0%, and 0.99, respectively) LNs.
CONCLUSIONS: According to the EI, this study raises concerns about the effectiveness of dissection in the posterior pancreaticoduodenal LNs in PHCC and LNs along the CHA in DCC.
METHODS: The efficacy index (EI) was calculated in patients who underwent surgery for PHCC (n = 134) and DCC (n = 135) by multiplying the frequency of metastasis to the LN station and the 5-year overall survival (OS) rate of patients with metastasis to that station.
RESULTS: In PHCC, the frequency of metastasis, 5-year OS rates, and the EI in para-aortic LNs (4.7%, 0%, and 0, respectively) and posterior pancreaticoduodenal LNs (8.1%, 0%, and 0, respectively) were lower than those in hepatoduodenal ligament LNs (30.1%, 24.1%, and 7.25, respectively) and LNs along the common hepatic artery (CHA) (16.2%, 15.0%, and 2.43, respectively). In DCC, these values were lower in LNs along the CHA (6.4%, 0%, and 0, respectively) than in the posterior pancreaticoduodenal LNs (31.2%, 34.5%, and 10.8, respectively), the hepatoduodenal ligament LNs (14.8%, 15.2%, and 2.25, respectively), and para-aortic (4.0%, 25.0%, and 0.99, respectively) LNs.
CONCLUSIONS: According to the EI, this study raises concerns about the effectiveness of dissection in the posterior pancreaticoduodenal LNs in PHCC and LNs along the CHA in DCC.
摘要：
背景：以前尚未在肝门部胆管癌（PHCC）和远端胆管癌（DCC）中充分研究每个站点淋巴结（LN）清扫的益处。
方法：通过将转移到LN站的频率和转移到该站的患者的5年总生存率（OS）率相乘，计算出接受PHCC（n=134）和DCC（n=135）手术的患者的疗效指数（EI）。
结果：在PHCC中，转移的频率，5年操作系统费率，和主动脉旁LN中的EI(4.7%，0%,和0）和胰十二指肠后LN（8.1%，0%,和0）分别低于肝十二指肠韧带LN（30.1％，24.1%,和7.25，分别）和LN沿肝总动脉（CHA）（16.2％，15.0%,和2.43）。在DCC中,这些值在CHA沿线的LN中较低(6.4%，0%,和0）分别高于后胰十二指肠LN（31.2%，34.5%,和10.8)，肝十二指肠韧带LN（14.8%，15.2%,和2.25)，和主动脉旁(4.0%，25.0%,和0.99，分别）LN。
结论：根据EI，这项研究引起了人们对PHCC中后胰十二指肠LN和DCC中沿CHA的LN的解剖有效性的担忧。
方法：通过将转移到LN站的频率和转移到该站的患者的5年总生存率（OS）率相乘，计算出接受PHCC（n=134）和DCC（n=135）手术的患者的疗效指数（EI）。
结果：在PHCC中，转移的频率，5年操作系统费率，和主动脉旁LN中的EI(4.7%，0%,和0）和胰十二指肠后LN（8.1%，0%,和0）分别低于肝十二指肠韧带LN（30.1％，24.1%,和7.25，分别）和LN沿肝总动脉（CHA）（16.2％，15.0%,和2.43）。在DCC中,这些值在CHA沿线的LN中较低(6.4%，0%,和0）分别高于后胰十二指肠LN（31.2%，34.5%,和10.8)，肝十二指肠韧带LN（14.8%，15.2%,和2.25)，和主动脉旁(4.0%，25.0%,和0.99，分别）LN。
结论：根据EI，这项研究引起了人们对PHCC中后胰十二指肠LN和DCC中沿CHA的LN的解剖有效性的担忧。
