A preoperative scoring system to predict lymph node metastasis in intrahepatic cholangiocarcinoma

Background The abnormality of imaging finding of lymph node (LN) has demonstrated unsatisfactory diagnostic accuracy for pathologic lymph node metastasis (LNM). We aimed to develop and validate a simple scoring system predicting LNM in patients with intrahepatic cholangiocarcinoma (iCCA) prior to su...

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Published in:Hepatology international 2023-08, Vol.17 (4), p.942-953
Main Authors: Rhee, Hyungjin, Lim, Hyun-Ji, Han, Kyunghwa, Yeom, Suk-Keu, Choi, Sang Hyun, Park, Ji Hoon, Cho, Eun-Suk, Park, Sumi, Lee, Mi-Jung, Choi, Gi Hong, Han, Dai Hoon, Lee, Seung Soo, Park, Mi-Suk
Format: Article
Language:English
Subjects:
Antigens
Bile ducts
Carcinoembryonic antigen
Cholangiocarcinoma
Colorectal Surgery
Hepatology
Lymph nodes
Lymphatic system
Magnetic resonance imaging
Medicine
Medicine & Public Health
Metastases
Metastasis
Original Article
Patients
Surgery
Training
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Summary:Background The abnormality of imaging finding of lymph node (LN) has demonstrated unsatisfactory diagnostic accuracy for pathologic lymph node metastasis (LNM). We aimed to develop and validate a simple scoring system predicting LNM in patients with intrahepatic cholangiocarcinoma (iCCA) prior to surgery based on MRI and clinical findings. Methods We retrospectively enrolled consecutive patients who underwent surgical resection for treatment-naïve iCCA from six institutions between January 2009 and December 2015. Patients who underwent lymph node dissection (LND) were randomly assigned to the training and validation cohorts at a 2:1 ratio, an¹ìd pathologic LN status was evaluated. Patients who did not undergo LND were assigned to the test cohort, and clinical LN status was evaluated. Using MRI and clinical findings, a preoperative LNM score was developed in the training cohort and validated in the validation and test cohorts. Results The training, validation, and test cohorts included 102, 53, and 118 patients, respectively. The preoperative LNM score consisted of serum carcinoembryonic antigen and two MRI findings (suspicious LN and bile duct invasion). The preoperative LNM score was associated with pathologic LNM in training ( p  
ISSN:1936-0533
1936-0541
DOI:10.1007/s12072-022-10477-7