Defining the possible therapeutic benefit of lymphadenectomy among patients undergoing hepatic resection for intrahepatic cholangiocarcinoma

Background The aim of the study was to investigate the therapeutic role of lymphadenectomy (LND) in patients with intrahepatic cholangiocarcinoma. Methods 826 patients who underwent liver resection were identified using the SEER database from 1988 to 2011. Two groups of patients were defined: 201 (24%) undergoing potentially therapeutic LND (group A, >3 lymph nodes (LN) removed), and 625 (76%) not receiving therapeutic LND (group B, ≤3 LNs removed). A propensity score analysis was performed to create a matched cohort of 402 patients (201 in either group). The survival benefit of therapeutic LND was also estimated using multivariate parametric analysis comparing two simulated cohorts of 826 patients. Results 1‐, 3‐, and 5‐year survival rates were 71%, 37%, and 27% for group A patients, and 73%, 37%, and 27% for matched group B patients (P = 0.656). When simulation analysis was performed, a moderate survival benefit of LND of 5.46 months was calculated (95%CI, 4.64–6.29). Considerable differences in LND survival benefit predictions were found according to patient's sex (males, 9.90 vs. females 1.16 months), age (≤60 years, 15 vs. >60 years, −1.34 months), and tumor size (>50 mm, 9.20 vs. ≤50 mm, −0.28). Conclusions LND therapeutic benefit among a subset of patients. Future work is required to investigate the role of routine LND among these patients. J. Surg. Oncol. 2016;113:685–691. © 2016 Wiley Periodicals, Inc.