Re-appraising the role of lymph node status in predicting survival in resected distal cholangiocarcinoma – A meta-analysis and systematic review

This systematic review and meta-analysis aimed to confirm the prognostic value of lymph node ratio (LNR), and determine an optimal LNR cut-off for overall survival (OS) in patients with distal cholangiocarcinoma (DCC) undergoing curative surgery. We additionally aimed to provide a consolidated revie...

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Bibliographic Details
Published in:European journal of surgical oncology 2021-06, Vol.47 (6), p.1267-1277
Main Authors: Chin, Ken Min, Di Martino, Marcello, Syn, Nicholas, Ielpo, Benedetto, Hilal, Mohammad Abu, Goh, Brian K.P., Koh, Ye Xin, Prieto, Mikel
Format: Article
Language:English
Subjects:
Distal cholangiocarcinoma
Lymph node
Lymph node ratio
Positive lymph node count
Survival
Total lymph node count
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Summary:This systematic review and meta-analysis aimed to confirm the prognostic value of lymph node ratio (LNR), and determine an optimal LNR cut-off for overall survival (OS) in patients with distal cholangiocarcinoma (DCC) undergoing curative surgery. We additionally aimed to provide a consolidated review of current evidence regarding prognostic significance of positive lymph node count (PLNC) and total lymph node count (TLNC). A systematic search of PubMed, EMBASE and Cochrane Library was conducted from inception to October 2020. Studies were included into meta-analysis if there was histological diagnosis, curative surgery, restriction to DCC and relevant LNR results. Quality assessment was performed using the Newcastle Ottawa Scale. Findings for 1228 patients were pooled across 6 studies. Meta-analysis delineated a dose-effect gradient in which higher LNR cut-offs correlated with larger pooled hazard ratios: 0
ISSN:0748-7983
1532-2157
DOI:10.1016/j.ejso.2021.01.004