Impact of Positive Lymph Nodes and Resection Margin Status on the Overall Survival of Patients with Resected Perihilar Cholangiocarcinoma: The ENSCCA Registry
Background: Lymph node metastasis and positive resection margins have been reported to be major determinants of overall survival (OS) and poor recurrence-free survival (RFS) for patients who underwent resection for perihilar cholangiocarcinoma (pCCA). However, the prognostic value of positive lymph...
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MDPI AG
2022-05-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/10/2389 |
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| author | Lynn E. Nooijen Jesus M. Banales Marieke T. de Boer Chiara Braconi Trine Folseraas Alejandro Forner Waclaw Holowko Frederik J. H. Hoogwater Heinz-Josef Klümpen Bas Groot Koerkamp Angela Lamarca Adelaida La Casta Flora López-López Laura Izquierdo-Sánchez Alexander Scheiter Kirsten Utpatel Rutger-Jan Swijnenburg Geert Kazemier Joris I. Erdmann |
| author_facet | Lynn E. Nooijen Jesus M. Banales Marieke T. de Boer Chiara Braconi Trine Folseraas Alejandro Forner Waclaw Holowko Frederik J. H. Hoogwater Heinz-Josef Klümpen Bas Groot Koerkamp Angela Lamarca Adelaida La Casta Flora López-López Laura Izquierdo-Sánchez Alexander Scheiter Kirsten Utpatel Rutger-Jan Swijnenburg Geert Kazemier Joris I. Erdmann |
| author_sort | Lynn E. Nooijen |
| collection | DOAJ |
| description | Background: Lymph node metastasis and positive resection margins have been reported to be major determinants of overall survival (OS) and poor recurrence-free survival (RFS) for patients who underwent resection for perihilar cholangiocarcinoma (pCCA). However, the prognostic value of positive lymph nodes independently from resection margin status on OS has not been evaluated. Methods: From the European Cholangiocarcinoma (ENSCCA) registry, patients who underwent resection for pCCA between 1994 and 2021 were included in this retrospective cohort study. The primary outcome was OS stratified for resection margin and lymph node status. The secondary outcome was recurrence-free survival. Results: A total of 325 patients from 11 different centers and six European countries were included. Of these, 194 (59.7%) patients had negative resection margins. In 113 (34.8%) patients, positive lymph nodes were found. Lymph node status, histological grade, and ECOG performance status were independent prognostic factors for survival. The median OS for N0R0, N0R1, N+R0, and N+R1 was 38, 30, 18, and 12 months, respectively (<i>p</i> < 0.001). Conclusion: These data indicate that in the presence of positive regional lymph nodes, resection margin status does not determine OS or RFS in patients with pCCA. Achieving negative margins in patients with positive nodes should not come at the expense of more extensive surgery and associated higher mortality. |
| first_indexed | 2024-03-10T03:12:36Z |
| format | Article |
| id | doaj.art-5fae689f2b2949caba1e39a59753a694 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T03:12:36Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-5fae689f2b2949caba1e39a59753a6942023-11-23T10:22:28ZengMDPI AGCancers2072-66942022-05-011410238910.3390/cancers14102389Impact of Positive Lymph Nodes and Resection Margin Status on the Overall Survival of Patients with Resected Perihilar Cholangiocarcinoma: The ENSCCA RegistryLynn E. Nooijen0Jesus M. Banales1Marieke T. de Boer2Chiara Braconi3Trine Folseraas4Alejandro Forner5Waclaw Holowko6Frederik J. H. Hoogwater7Heinz-Josef Klümpen8Bas Groot Koerkamp9Angela Lamarca10Adelaida La Casta11Flora López-López12Laura Izquierdo-Sánchez13Alexander Scheiter14Kirsten Utpatel15Rutger-Jan Swijnenburg16Geert Kazemier17Joris I. Erdmann18Department of Surgery, Amsterdam UMC—Location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The NetherlandsDepartment of Liver and Gastrointestinal Diseases, Biodonostia Health Research Institute, Donostia University Hospital, University of the Basque Country (UPV/EHU), 20014 San Sebastián, SpainSection of HPB Surgery & Liver Transplantation, Department of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsThe Royal Marsden NHS Trust, London SW3 6JJ, UKNorwegian PSC Research Center and Section of Gastroenterology, Department of Transplantation Medicine, Division of Surgery, Inflammatory Medicine and Transplantation, Oslo University Hospital Rikshospitalet, 0372 Oslo, NorwayBCLC Group, Liver Unit, Hospital Clinic Barcelona, IDIBAPS, CIBEREHD, University Barcelona, 08036 Barcelona, SpainDepartment of General, Transplant and Liver Surgery, Medical University of Warsaw, 02-091 Warsaw, PolandSection of HPB Surgery & Liver Transplantation, Department of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The NetherlandsCancer Center Amsterdam, Cancer Treatment and Quality of Life, 1081 HV Amsterdam, The NetherlandsDepartment of Surgery, Erasmus MC Cancer Institute, 3015 GD Rotterdam, The NetherlandsDepartment of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UKDepartment of Medical Oncology, Biodonostia Health Research Institute, Donostia University Hospital, University of the Basque Country (UPV/EHU), 20014 San Sebastián, SpainDepartment of Medical Oncology, Hospital Universitario 12 de Octubre, 28041 Madrid, SpainDepartment of Liver and Gastrointestinal Diseases, Biodonostia Health Research Institute, Donostia University Hospital, University of the Basque Country (UPV/EHU), 20014 San Sebastián, SpainInstitute of Pathology, University of Regensburg, 93053 Regensburg, GermanyInstitute of Pathology, University of Regensburg, 93053 Regensburg, GermanyCancer Center Amsterdam, Cancer Treatment and Quality of Life, 1081 HV Amsterdam, The NetherlandsDepartment of Surgery, Amsterdam UMC—Location Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The NetherlandsCancer Center Amsterdam, Cancer Treatment and Quality of Life, 1081 HV Amsterdam, The NetherlandsBackground: Lymph node metastasis and positive resection margins have been reported to be major determinants of overall survival (OS) and poor recurrence-free survival (RFS) for patients who underwent resection for perihilar cholangiocarcinoma (pCCA). However, the prognostic value of positive lymph nodes independently from resection margin status on OS has not been evaluated. Methods: From the European Cholangiocarcinoma (ENSCCA) registry, patients who underwent resection for pCCA between 1994 and 2021 were included in this retrospective cohort study. The primary outcome was OS stratified for resection margin and lymph node status. The secondary outcome was recurrence-free survival. Results: A total of 325 patients from 11 different centers and six European countries were included. Of these, 194 (59.7%) patients had negative resection margins. In 113 (34.8%) patients, positive lymph nodes were found. Lymph node status, histological grade, and ECOG performance status were independent prognostic factors for survival. The median OS for N0R0, N0R1, N+R0, and N+R1 was 38, 30, 18, and 12 months, respectively (<i>p</i> < 0.001). Conclusion: These data indicate that in the presence of positive regional lymph nodes, resection margin status does not determine OS or RFS in patients with pCCA. Achieving negative margins in patients with positive nodes should not come at the expense of more extensive surgery and associated higher mortality.https://www.mdpi.com/2072-6694/14/10/2389perihilar cholangiocarcinomalymph nodesresection marginoverall survivalrecurrence-free survival |
| spellingShingle | Lynn E. Nooijen Jesus M. Banales Marieke T. de Boer Chiara Braconi Trine Folseraas Alejandro Forner Waclaw Holowko Frederik J. H. Hoogwater Heinz-Josef Klümpen Bas Groot Koerkamp Angela Lamarca Adelaida La Casta Flora López-López Laura Izquierdo-Sánchez Alexander Scheiter Kirsten Utpatel Rutger-Jan Swijnenburg Geert Kazemier Joris I. Erdmann Impact of Positive Lymph Nodes and Resection Margin Status on the Overall Survival of Patients with Resected Perihilar Cholangiocarcinoma: The ENSCCA Registry Cancers perihilar cholangiocarcinoma lymph nodes resection margin overall survival recurrence-free survival |
| title | Impact of Positive Lymph Nodes and Resection Margin Status on the Overall Survival of Patients with Resected Perihilar Cholangiocarcinoma: The ENSCCA Registry |
| title_full | Impact of Positive Lymph Nodes and Resection Margin Status on the Overall Survival of Patients with Resected Perihilar Cholangiocarcinoma: The ENSCCA Registry |
| title_fullStr | Impact of Positive Lymph Nodes and Resection Margin Status on the Overall Survival of Patients with Resected Perihilar Cholangiocarcinoma: The ENSCCA Registry |
| title_full_unstemmed | Impact of Positive Lymph Nodes and Resection Margin Status on the Overall Survival of Patients with Resected Perihilar Cholangiocarcinoma: The ENSCCA Registry |
| title_short | Impact of Positive Lymph Nodes and Resection Margin Status on the Overall Survival of Patients with Resected Perihilar Cholangiocarcinoma: The ENSCCA Registry |
| title_sort | impact of positive lymph nodes and resection margin status on the overall survival of patients with resected perihilar cholangiocarcinoma the enscca registry |
| topic | perihilar cholangiocarcinoma lymph nodes resection margin overall survival recurrence-free survival |
| url | https://www.mdpi.com/2072-6694/14/10/2389 |
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