Management of Lymph Nodes During Resection of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma: A Systematic Review
Management of Lymph Nodes During Resection of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma: A Systematic Review
复制标题
DOI：
10.1007/s11605-014-2667-1
复制
发表时间：
2014-12-01
影响因子：
3.2
通讯作者：
Pawlik, Timothy M.
中科院分区：
文献类型：
--
作者：
Amini, Neda;Ejaz, Aslam;Pawlik, Timothy M.
淋巴结清扫术（LND）在肝细胞癌（HCC）或肝内胆管细胞癌（ICC）患者治疗中的作用仍存在争议。我们试图系统地回顾所有可用的证据，以确定LND在HCC和ICC患者中的作用。从PubMed、科克伦、Embase、Scopus和Web of Science数据库中识别了报告LND、淋巴结转移（LNM）以及HCC或ICC患者生存期的短期和长期结局的研究。使用标准技术提取、合成和分析数据。共识别出HCC和ICC的参考文献分别为603篇和434篇。在HCC患者中，LND的总体患病率为51.6%（95%置信区间（CI）19.7-83.5），相关LNM发生率为44.5%（95% CI 27.4-61.7）。LNM的3年和5年生存率分别为27.5%和20.8%。在ICC患者中，大多数患者78.5%（95%CI 76.2-80.7）接受了LND; 45.2%（95%CI 39.2-51.2）接受了LNM。伴有LNM的ICC患者的3年和5年生存率分别为0.2%（95%CI 0-0.7）和0%。虽然没有足够的数据推荐所有HCC或ICC患者常规LND，但LND的潜在预后价值表明，至少应在手术时考虑LND。
The role of lymph node dissection (LND) in the treatment of patients with hepatocellular carcinoma (HCC) or intrahepatic cholangiocarcinoma (ICC) remains controversial. We sought to systematically review all available evidence to determine the role of LND in patients with HCC and ICC. Studies that reported on LND, lymph node metastasis (LNM), and short- and long-term outcomes for patients with HCC or ICC survival were identified from PubMed, Cochrane, Embase, Scopus, and Web of Science databases. Data were extracted, synthesized, and analyzed using standard techniques. A total of 603 and 434 references were identified for HCC and ICC, respectively. Among HCC patients, the overall prevalence of LND was 51.6 % (95 % confidence interval (CI) 19.7-83.5) with an associated LNM incidence of 44.5 % (95 % CI 27.4-61.7). LNM was associated with a 3- and 5-year survival of 27.5 and 20.8 %, respectively. Among ICC patients, most patients 78.5 % (95 % CI 76.2-80.7) underwent LND; 45.2 % (95 % CI 39.2-51.2) had LNM. Three and 5-year survival among ICC patients with LNM was 0.2 % (95 % CI 0-0.7) and 0 %, respectively. While there are insufficient data to recommend a routine LND in all patients with HCC or ICC, the potential prognostic value of LND suggests that LND should at least be considered at the time of surgery.