Ann Hepatobiliary Pancreat Surg.  2022 May;26(2):168-177. 10.14701/ahbps.21-126.

The prognostic value of the lymph node ratio in patients with distal cholangiocarcinoma after curative intended surgery: A single-center retrospective study

Affiliations
  • 1Department of Surgery, Chonnam National University Medical School, Gwangju, Korea

Abstract

Backgrounds/Aims
The goal of the present study was to evaluate the prognostic value of lymph node ratio (LNR) in distal cholangiocarcinoma (DCC) after curative intended surgery.
Methods
Clinicopathological data of 162 DCC patients who underwent radical intended surgery between 2012 and 2020 were analyzed retrospectively. Prognostic factors related to overall survival (OS) and disease-free survival (DFS) were evaluated.
Results
Median OS time and DFS time were 41 and 29 months, and 5-year OS rate and DFS rate were 44.7% and 38.1%, respectively. In the univariate analysis, significant prognostic factors for OS were histologic differentiation, American Joint Committee on Cancer (AJCC) stage, positive lymph node count, LNR, R1 resection, and perineural invasion. Preoperative carcinoembryonic antigen, carbohydrate antigen 19-9, infiltrative type, histologic differentiation, AJCC stage, positive lymph node count, LNR, R1 resection, perineural invasion, and lymph-vascular invasion were significant prognostic factors for DFS in the univariate analysis. In the multivariate analysis, histologic differentiation, R1 resection, and LNR were the independent prognostic factors for both OS and DFS. The LNR ≥ 0.2 group had a significantly poor prognosis in terms of OS (hazard ratio, 3.915; p = 0.002) and DFS (hazard ratio, 5.840; p < 0.001).
Conclusions
LNR has significant value as a prognostic factor of DCC related to OS and DFS. LNR has the potential to be used as a modified staging system with furthermore studies.

Keyword

Cholangiocarcinoma; Pancreaticoduodenectomy; Lymph node ratio; Survival

Figure

  • Fig. 1 Cumulative overall survival ratio according to survival time (A), and cumulative disease-free survival according to survival time (B) in the LNR groups. Significant differences of survival in the LNR group were demonstrated. LNR, lymph node ratio.


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