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Abstract：
UNASSIGNED: Lymph node status is a prominent prognostic factor for intrahepatic cholangiocarcinoma (ICC). However, the prognostic value of performing lymph node dissection (LND) in patients with clinical node-negative ICC remains controversial. The aim of this study was to evaluate the clinical value of LND on long-term outcomes in this subgroup of patients.
UNASSIGNED: We retrospectively analyzed patients who underwent radical liver resection for clinically node-negative ICC from three tertiary hepatobiliary centers. The propensity score matching analysis at 1:1 ratio based on clinicopathological data was conducted between patients with and without LND. Recurrence-free survival (RFS) and overall survival (OS) were compared in the matched cohort.
UNASSIGNED: Among 303 patients who underwent radical liver resection for ICC, 48 patients with clinically positive nodes were excluded, and a total of 159 clinically node-negative ICC patients were finally eligible for the study, with 102 in the LND group and 57 in the non-LND group. After propensity score matching, two well-balanced groups of 51 patients each were analyzed. No significant difference of median RFS (12.0 vs. 10.0 months, P = 0.37) and median OS (22.0 vs. 26.0 months, P = 0.47) was observed between the LND and non-LND group. Also, LND was not identified as one of the independent risks for survival. Among 51 patients who received LND, 11 patients were with positive lymph nodes (lymph node metastasis (LNM) (+)) and presented significantly worse outcomes than those with LND (-). On the other hand, postoperative adjuvant therapy was the independent risk factor for both RFS (hazard ratio (HR): 0.623, 95% confidence interval (CI): 0.393 - 0.987, P = 0.044) and OS (HR: 0.585, 95% CI: 0.359 - 0.952, P = 0.031). Furthermore, postoperative adjuvant therapy was associated with prolonged survivals of non-LND patients (P = 0.02 for RFS and P = 0.03 for OS).
UNASSIGNED: Based on the data, we found that LND did not significantly improve the prognosis of patients with clinically node-negative ICC. Postoperative adjuvant therapy was associated with prolonged survival of ICC patients, especially in non-LND individuals.
UNASSIGNED: We retrospectively analyzed patients who underwent radical liver resection for clinically node-negative ICC from three tertiary hepatobiliary centers. The propensity score matching analysis at 1:1 ratio based on clinicopathological data was conducted between patients with and without LND. Recurrence-free survival (RFS) and overall survival (OS) were compared in the matched cohort.
UNASSIGNED: Among 303 patients who underwent radical liver resection for ICC, 48 patients with clinically positive nodes were excluded, and a total of 159 clinically node-negative ICC patients were finally eligible for the study, with 102 in the LND group and 57 in the non-LND group. After propensity score matching, two well-balanced groups of 51 patients each were analyzed. No significant difference of median RFS (12.0 vs. 10.0 months, P = 0.37) and median OS (22.0 vs. 26.0 months, P = 0.47) was observed between the LND and non-LND group. Also, LND was not identified as one of the independent risks for survival. Among 51 patients who received LND, 11 patients were with positive lymph nodes (lymph node metastasis (LNM) (+)) and presented significantly worse outcomes than those with LND (-). On the other hand, postoperative adjuvant therapy was the independent risk factor for both RFS (hazard ratio (HR): 0.623, 95% confidence interval (CI): 0.393 - 0.987, P = 0.044) and OS (HR: 0.585, 95% CI: 0.359 - 0.952, P = 0.031). Furthermore, postoperative adjuvant therapy was associated with prolonged survivals of non-LND patients (P = 0.02 for RFS and P = 0.03 for OS).
UNASSIGNED: Based on the data, we found that LND did not significantly improve the prognosis of patients with clinically node-negative ICC. Postoperative adjuvant therapy was associated with prolonged survival of ICC patients, especially in non-LND individuals.
摘要：
■淋巴结状态是肝内胆管癌（ICC）的重要预后因素。然而,临床淋巴结阴性ICC患者进行淋巴结清扫(LND)的预后价值仍存在争议.这项研究的目的是评估LND对该亚组患者长期结局的临床价值。
■我们回顾性分析了来自三个三级肝胆中心的因临床淋巴结阴性ICC而接受根治性肝切除术的患者。在有和没有LND的患者之间进行基于临床病理数据的1:1比例的倾向评分匹配分析。在匹配的队列中比较了无复发生存率（RFS）和总生存率（OS）。
■在303例接受根治性肝切除术的患者中，48例临床阳性淋巴结患者被排除在外，共有159名临床淋巴结阴性的ICC患者最终符合研究条件，LND组102名，非LND组57名。在倾向得分匹配后，我们对两组均衡的51例患者进行了分析.中位数RFS无显著差异（12.0vs.10.0个月,P=0.37）和中位OS（22.0与26.0个月，在LND组和非LND组之间观察到P=0.47）。此外，LND未被确定为生存的独立风险之一。在接受LND的51名患者中，11例患者淋巴结阳性（淋巴结转移（LNM）（）），结果明显比LND（-）差。另一方面,术后辅助治疗是RFS(风险比(HR):0.623,95%置信区间(CI):0.393~0.987,P=0.044)和OS(HR:0.585,95%CI:0.359~0.952,P=0.031)的独立危险因素.此外，术后辅助治疗与非LND患者的生存期延长相关(RFSP=0.02,OSP=0.03).
■根据数据，我们发现LND并不能显著改善临床淋巴结阴性ICC患者的预后.术后辅助治疗与ICC患者生存期延长相关,特别是在非LND个人中。
■我们回顾性分析了来自三个三级肝胆中心的因临床淋巴结阴性ICC而接受根治性肝切除术的患者。在有和没有LND的患者之间进行基于临床病理数据的1:1比例的倾向评分匹配分析。在匹配的队列中比较了无复发生存率（RFS）和总生存率（OS）。
■在303例接受根治性肝切除术的患者中，48例临床阳性淋巴结患者被排除在外，共有159名临床淋巴结阴性的ICC患者最终符合研究条件，LND组102名，非LND组57名。在倾向得分匹配后，我们对两组均衡的51例患者进行了分析.中位数RFS无显著差异（12.0vs.10.0个月,P=0.37）和中位OS（22.0与26.0个月，在LND组和非LND组之间观察到P=0.47）。此外，LND未被确定为生存的独立风险之一。在接受LND的51名患者中，11例患者淋巴结阳性（淋巴结转移（LNM）（）），结果明显比LND（-）差。另一方面,术后辅助治疗是RFS(风险比(HR):0.623,95%置信区间(CI):0.393~0.987,P=0.044)和OS(HR:0.585,95%CI:0.359~0.952,P=0.031)的独立危险因素.此外，术后辅助治疗与非LND患者的生存期延长相关(RFSP=0.02,OSP=0.03).
■根据数据，我们发现LND并不能显著改善临床淋巴结阴性ICC患者的预后.术后辅助治疗与ICC患者生存期延长相关,特别是在非LND个人中。
