Is lymph node dissection necessary for resectable intrahepatic cholangiocarcinoma? A systematic review and meta-analysis
The objective of this meta-analysis was to evaluate the effectiveness and safety of lymph node dissection (LND) in patients with intrahepatic cholangiocarcinoma (ICC). A literature search with a date range of January 2000 to January 2018 was performed to identify studies comparing lymph node dissect...
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| Veröffentlicht in: | HPB (Oxford, England) England), 2019-07, Vol.21 (7), p.784-792 |
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| creator | Zhou, Rui Lu, Dihan Li, Wenda Tan, Wenliang Zhu, Sicong Chen, Xianqing Min, Jun Shang, Changzhen Chen, Yajin |
| description | The objective of this meta-analysis was to evaluate the effectiveness and safety of lymph node dissection (LND) in patients with intrahepatic cholangiocarcinoma (ICC).
A literature search with a date range of January 2000 to January 2018 was performed to identify studies comparing lymph node dissection (LND+) with non-lymph node dissection (LND-) for patients with ICC. The LND + group was further divided into positive (LND + N+) and negative (LND + N-) lymph node status groups based on pathological analysis.
13 studies including 1377 patients were eligible. There were no significant differences in overall survival (OS) (HR 1.13, 95% CI 0.94–1.36; P = 0.20), disease-free survival (DFS) (HR 1.23, 95% CI 0.94–1.60; P = 0.13), or recurrence (OR 1.39, 95% CI 0.90–2.15; P = 0.14) between LND + group and LND-group. Postoperative morbidity was significantly higher in the LND + group (OR 2.67, 95% CI 1.74–4.10; P |
| doi_str_mv | 10.1016/j.hpb.2018.12.011 |
| format | Article |
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A literature search with a date range of January 2000 to January 2018 was performed to identify studies comparing lymph node dissection (LND+) with non-lymph node dissection (LND-) for patients with ICC. The LND + group was further divided into positive (LND + N+) and negative (LND + N-) lymph node status groups based on pathological analysis.
13 studies including 1377 patients were eligible. There were no significant differences in overall survival (OS) (HR 1.13, 95% CI 0.94–1.36; P = 0.20), disease-free survival (DFS) (HR 1.23, 95% CI 0.94–1.60; P = 0.13), or recurrence (OR 1.39, 95% CI 0.90–2.15; P = 0.14) between LND + group and LND-group. Postoperative morbidity was significantly higher in the LND + group (OR 2.67, 95% CI 1.74–4.10; P < 0.001). A subset analysis showed that OS was similar between LND + N- and LND-groups (HR 1.13, 95% CI 0.82–1.56; P = 0.450). However when comparing, OS of the LND-group to the LND+N+ group there was a significant increase in OS for the LND-group (HR 3.26, 95% CI 1.85–5.76; P < 0.001).
LND does not seem to positively affect overall survival and is associated with increased post-operative morbidity.</description><identifier>ISSN: 1365-182X</identifier><identifier>EISSN: 1477-2574</identifier><identifier>DOI: 10.1016/j.hpb.2018.12.011</identifier><identifier>PMID: 30878490</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Bile Duct Neoplasms - mortality ; Bile Duct Neoplasms - secondary ; Bile Duct Neoplasms - surgery ; Cholangiocarcinoma - mortality ; Cholangiocarcinoma - secondary ; Cholangiocarcinoma - surgery ; Disease Progression ; Disease-Free Survival ; Hepatectomy - adverse effects ; Hepatectomy - mortality ; Humans ; Lymph Node Excision - adverse effects ; Lymph Node Excision - mortality ; Lymph Nodes - pathology ; Lymph Nodes - surgery ; Lymphatic Metastasis ; Risk Factors ; Time Factors</subject><ispartof>HPB (Oxford, England), 2019-07, Vol.21 (7), p.784-792</ispartof><rights>2019 International Hepato-Pancreato-Biliary Association Inc.</rights><rights>Copyright © 2019 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c462t-287e3b369607d8266e6e3819589183bd6164ffbf694daac6bf55c26e38afa0da3</citedby><cites>FETCH-LOGICAL-c462t-287e3b369607d8266e6e3819589183bd6164ffbf694daac6bf55c26e38afa0da3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27929,27930</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30878490$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhou, Rui</creatorcontrib><creatorcontrib>Lu, Dihan</creatorcontrib><creatorcontrib>Li, Wenda</creatorcontrib><creatorcontrib>Tan, Wenliang</creatorcontrib><creatorcontrib>Zhu, Sicong</creatorcontrib><creatorcontrib>Chen, Xianqing</creatorcontrib><creatorcontrib>Min, Jun</creatorcontrib><creatorcontrib>Shang, Changzhen</creatorcontrib><creatorcontrib>Chen, Yajin</creatorcontrib><title>Is lymph node dissection necessary for resectable intrahepatic cholangiocarcinoma? A systematic review and meta-analysis</title><title>HPB (Oxford, England)</title><addtitle>HPB (Oxford)</addtitle><description>The objective of this meta-analysis was to evaluate the effectiveness and safety of lymph node dissection (LND) in patients with intrahepatic cholangiocarcinoma (ICC).
A literature search with a date range of January 2000 to January 2018 was performed to identify studies comparing lymph node dissection (LND+) with non-lymph node dissection (LND-) for patients with ICC. The LND + group was further divided into positive (LND + N+) and negative (LND + N-) lymph node status groups based on pathological analysis.
13 studies including 1377 patients were eligible. There were no significant differences in overall survival (OS) (HR 1.13, 95% CI 0.94–1.36; P = 0.20), disease-free survival (DFS) (HR 1.23, 95% CI 0.94–1.60; P = 0.13), or recurrence (OR 1.39, 95% CI 0.90–2.15; P = 0.14) between LND + group and LND-group. Postoperative morbidity was significantly higher in the LND + group (OR 2.67, 95% CI 1.74–4.10; P < 0.001). A subset analysis showed that OS was similar between LND + N- and LND-groups (HR 1.13, 95% CI 0.82–1.56; P = 0.450). However when comparing, OS of the LND-group to the LND+N+ group there was a significant increase in OS for the LND-group (HR 3.26, 95% CI 1.85–5.76; P < 0.001).
LND does not seem to positively affect overall survival and is associated with increased post-operative morbidity.</description><subject>Bile Duct Neoplasms - mortality</subject><subject>Bile Duct Neoplasms - secondary</subject><subject>Bile Duct Neoplasms - surgery</subject><subject>Cholangiocarcinoma - mortality</subject><subject>Cholangiocarcinoma - secondary</subject><subject>Cholangiocarcinoma - surgery</subject><subject>Disease Progression</subject><subject>Disease-Free Survival</subject><subject>Hepatectomy - adverse effects</subject><subject>Hepatectomy - mortality</subject><subject>Humans</subject><subject>Lymph Node Excision - adverse effects</subject><subject>Lymph Node Excision - mortality</subject><subject>Lymph Nodes - pathology</subject><subject>Lymph Nodes - surgery</subject><subject>Lymphatic Metastasis</subject><subject>Risk Factors</subject><subject>Time Factors</subject><issn>1365-182X</issn><issn>1477-2574</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1v1DAQhi0EoqXlB_RS-cglwR-J46iHqlrxUakSF5B6sxx7wnqV2MGTpey_x8sWjpw8sp731cxDyBVnNWdcvd_V22WoBeO65qJmnL8g57zpukq0XfOyzFK1Fdfi8Yy8QdwxJkqsf03OJNOdbnp2Tn7dI50O87KlMXmgPiCCW0OKNIIDRJsPdEyZZjj-22ECGuKa7RYWuwZH3TZNNn4PydnsQkyzvaV3FA-4wvwHyPAzwBO10dMZVlvZaKcDBrwkr0Y7Ibx9fi_It48fvm4-Vw9fPt1v7h4q1yixVkJ3IAepesU6r4VSoEBq3re651oOXnHVjOMwqr7x1jo1jG3rxJGxo2Xeygvy7tS75PRjD7iaOaCDqWwNaY9G8F4qJnohC8pPqMsJMcNolhzmYsBwZo7Czc4U4eYo3HBhivCSuX6u3w8z-H-Jv4YLcHMCoBxZVGSDLkB04EMuRo1P4T_1vwFoSpNx</recordid><startdate>201907</startdate><enddate>201907</enddate><creator>Zhou, Rui</creator><creator>Lu, Dihan</creator><creator>Li, Wenda</creator><creator>Tan, Wenliang</creator><creator>Zhu, Sicong</creator><creator>Chen, Xianqing</creator><creator>Min, Jun</creator><creator>Shang, Changzhen</creator><creator>Chen, Yajin</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201907</creationdate><title>Is lymph node dissection necessary for resectable intrahepatic cholangiocarcinoma? A systematic review and meta-analysis</title><author>Zhou, Rui ; Lu, Dihan ; Li, Wenda ; Tan, Wenliang ; Zhu, Sicong ; Chen, Xianqing ; Min, Jun ; Shang, Changzhen ; Chen, Yajin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c462t-287e3b369607d8266e6e3819589183bd6164ffbf694daac6bf55c26e38afa0da3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Bile Duct Neoplasms - mortality</topic><topic>Bile Duct Neoplasms - secondary</topic><topic>Bile Duct Neoplasms - surgery</topic><topic>Cholangiocarcinoma - mortality</topic><topic>Cholangiocarcinoma - secondary</topic><topic>Cholangiocarcinoma - surgery</topic><topic>Disease Progression</topic><topic>Disease-Free Survival</topic><topic>Hepatectomy - adverse effects</topic><topic>Hepatectomy - mortality</topic><topic>Humans</topic><topic>Lymph Node Excision - adverse effects</topic><topic>Lymph Node Excision - mortality</topic><topic>Lymph Nodes - pathology</topic><topic>Lymph Nodes - surgery</topic><topic>Lymphatic Metastasis</topic><topic>Risk Factors</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhou, Rui</creatorcontrib><creatorcontrib>Lu, Dihan</creatorcontrib><creatorcontrib>Li, Wenda</creatorcontrib><creatorcontrib>Tan, Wenliang</creatorcontrib><creatorcontrib>Zhu, Sicong</creatorcontrib><creatorcontrib>Chen, Xianqing</creatorcontrib><creatorcontrib>Min, Jun</creatorcontrib><creatorcontrib>Shang, Changzhen</creatorcontrib><creatorcontrib>Chen, Yajin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>HPB (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhou, Rui</au><au>Lu, Dihan</au><au>Li, Wenda</au><au>Tan, Wenliang</au><au>Zhu, Sicong</au><au>Chen, Xianqing</au><au>Min, Jun</au><au>Shang, Changzhen</au><au>Chen, Yajin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is lymph node dissection necessary for resectable intrahepatic cholangiocarcinoma? A systematic review and meta-analysis</atitle><jtitle>HPB (Oxford, England)</jtitle><addtitle>HPB (Oxford)</addtitle><date>2019-07</date><risdate>2019</risdate><volume>21</volume><issue>7</issue><spage>784</spage><epage>792</epage><pages>784-792</pages><issn>1365-182X</issn><eissn>1477-2574</eissn><abstract>The objective of this meta-analysis was to evaluate the effectiveness and safety of lymph node dissection (LND) in patients with intrahepatic cholangiocarcinoma (ICC).
A literature search with a date range of January 2000 to January 2018 was performed to identify studies comparing lymph node dissection (LND+) with non-lymph node dissection (LND-) for patients with ICC. The LND + group was further divided into positive (LND + N+) and negative (LND + N-) lymph node status groups based on pathological analysis.
13 studies including 1377 patients were eligible. There were no significant differences in overall survival (OS) (HR 1.13, 95% CI 0.94–1.36; P = 0.20), disease-free survival (DFS) (HR 1.23, 95% CI 0.94–1.60; P = 0.13), or recurrence (OR 1.39, 95% CI 0.90–2.15; P = 0.14) between LND + group and LND-group. Postoperative morbidity was significantly higher in the LND + group (OR 2.67, 95% CI 1.74–4.10; P < 0.001). A subset analysis showed that OS was similar between LND + N- and LND-groups (HR 1.13, 95% CI 0.82–1.56; P = 0.450). However when comparing, OS of the LND-group to the LND+N+ group there was a significant increase in OS for the LND-group (HR 3.26, 95% CI 1.85–5.76; P < 0.001).
LND does not seem to positively affect overall survival and is associated with increased post-operative morbidity.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>30878490</pmid><doi>10.1016/j.hpb.2018.12.011</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Bile Duct Neoplasms - mortality Bile Duct Neoplasms - secondary Bile Duct Neoplasms - surgery Cholangiocarcinoma - mortality Cholangiocarcinoma - secondary Cholangiocarcinoma - surgery Disease Progression Disease-Free Survival Hepatectomy - adverse effects Hepatectomy - mortality Humans Lymph Node Excision - adverse effects Lymph Node Excision - mortality Lymph Nodes - pathology Lymph Nodes - surgery Lymphatic Metastasis Risk Factors Time Factors |
| title | Is lymph node dissection necessary for resectable intrahepatic cholangiocarcinoma? A systematic review and meta-analysis |
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