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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 |
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| creator | 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 |
| description | 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
|
| doi_str_mv | 10.1007/s12072-022-10477-7 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2768811768</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2768811768</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-3479eb11883d7ac5d6d5f2e7d9528494051470e0ec44c47e5cb34775f3fefe3b3</originalsourceid><addsrcrecordid>eNp9kUtLAzEUhYMotlb_gAsJuHEzmudkZlmKLyi40XVIM3falM5kTGaE_ntTWxVcCJckkO-ce7kHoUtKbikh6i5SRhTLCGMZJUKpTB2hMS15nhEp6PHPm_MROotxTYiUOc1P0YjneVGSkoyRmeIugO8gmN59AI7WB9cucdzGHhrc-9135WyPN9umW-HWV4Ab6E1M5SJ2bao-mBV0ycBiu_Ib0y6dtyZY1_rGnKOT2mwiXBzuCXp7uH-dPWXzl8fn2XSeWa5kn3GhSlhQWhS8UsbKKq9kzUBVpWSFKAWRVCgCBKwQViiQdpEkSta8hhr4gk_Qzd63C_59gNjrxkULmzQO-CFqpvKioDSdCb3-g679ENo0nU69uFSsJHmi2J6ywccYoNZdcI0JW02J3gWg9wHoFID-CkCrJLo6WA-LBqofyffGE8D3QOx2i4bw2_sf20-xcpGg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2843572906</pqid></control><display><type>article</type><title>A preoperative scoring system to predict lymph node metastasis in intrahepatic cholangiocarcinoma</title><source>Springer Link</source><creator>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</creator><creatorcontrib>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</creatorcontrib><description>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
< 0.001) and validation (
p
= 0.010) cohorts and clinical LNM in test cohort (
p
< 0.001). The preoperative LNM score outperformed MRI-suspicious LN alone in predicting pathologic LNM (area under the curve, 0.703 vs. 0.604,
p
= 0.004). The preoperative LNM score was also associated with overall survival in all cohorts (
p
< 0.001).
Conclusions
Our preoperative LNM score was significantly associated with pathologic or clinical LNM and outperformed MRI-suspicious LN alone.</description><identifier>ISSN: 1936-0533</identifier><identifier>EISSN: 1936-0541</identifier><identifier>DOI: 10.1007/s12072-022-10477-7</identifier><identifier>PMID: 36689090</identifier><language>eng</language><publisher>New Delhi: Springer India</publisher><subject>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</subject><ispartof>Hepatology international, 2023-08, Vol.17 (4), p.942-953</ispartof><rights>Asian Pacific Association for the Study of the Liver 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. Asian Pacific Association for the Study of the Liver.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-3479eb11883d7ac5d6d5f2e7d9528494051470e0ec44c47e5cb34775f3fefe3b3</citedby><cites>FETCH-LOGICAL-c375t-3479eb11883d7ac5d6d5f2e7d9528494051470e0ec44c47e5cb34775f3fefe3b3</cites><orcidid>0000-0002-6898-6617 ; 0000-0003-2787-7876 ; 0000-0001-7759-4458 ; 0000-0002-5687-7237 ; 0000-0002-3390-9793 ; 0000-0002-1593-3773 ; 0000-0001-5817-2444 ; 0000-0002-5518-2249 ; 0000-0002-6794-4909 ; 0000-0001-5537-2360 ; 0000-0003-3244-9171</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36689090$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rhee, Hyungjin</creatorcontrib><creatorcontrib>Lim, Hyun-Ji</creatorcontrib><creatorcontrib>Han, Kyunghwa</creatorcontrib><creatorcontrib>Yeom, Suk-Keu</creatorcontrib><creatorcontrib>Choi, Sang Hyun</creatorcontrib><creatorcontrib>Park, Ji Hoon</creatorcontrib><creatorcontrib>Cho, Eun-Suk</creatorcontrib><creatorcontrib>Park, Sumi</creatorcontrib><creatorcontrib>Lee, Mi-Jung</creatorcontrib><creatorcontrib>Choi, Gi Hong</creatorcontrib><creatorcontrib>Han, Dai Hoon</creatorcontrib><creatorcontrib>Lee, Seung Soo</creatorcontrib><creatorcontrib>Park, Mi-Suk</creatorcontrib><title>A preoperative scoring system to predict lymph node metastasis in intrahepatic cholangiocarcinoma</title><title>Hepatology international</title><addtitle>Hepatol Int</addtitle><addtitle>Hepatol Int</addtitle><description>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
< 0.001) and validation (
p
= 0.010) cohorts and clinical LNM in test cohort (
p
< 0.001). The preoperative LNM score outperformed MRI-suspicious LN alone in predicting pathologic LNM (area under the curve, 0.703 vs. 0.604,
p
= 0.004). The preoperative LNM score was also associated with overall survival in all cohorts (
p
< 0.001).
Conclusions
Our preoperative LNM score was significantly associated with pathologic or clinical LNM and outperformed MRI-suspicious LN alone.</description><subject>Antigens</subject><subject>Bile ducts</subject><subject>Carcinoembryonic antigen</subject><subject>Cholangiocarcinoma</subject><subject>Colorectal Surgery</subject><subject>Hepatology</subject><subject>Lymph nodes</subject><subject>Lymphatic system</subject><subject>Magnetic resonance imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Original Article</subject><subject>Patients</subject><subject>Surgery</subject><subject>Training</subject><issn>1936-0533</issn><issn>1936-0541</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kUtLAzEUhYMotlb_gAsJuHEzmudkZlmKLyi40XVIM3falM5kTGaE_ntTWxVcCJckkO-ce7kHoUtKbikh6i5SRhTLCGMZJUKpTB2hMS15nhEp6PHPm_MROotxTYiUOc1P0YjneVGSkoyRmeIugO8gmN59AI7WB9cucdzGHhrc-9135WyPN9umW-HWV4Ab6E1M5SJ2bao-mBV0ycBiu_Ib0y6dtyZY1_rGnKOT2mwiXBzuCXp7uH-dPWXzl8fn2XSeWa5kn3GhSlhQWhS8UsbKKq9kzUBVpWSFKAWRVCgCBKwQViiQdpEkSta8hhr4gk_Qzd63C_59gNjrxkULmzQO-CFqpvKioDSdCb3-g679ENo0nU69uFSsJHmi2J6ywccYoNZdcI0JW02J3gWg9wHoFID-CkCrJLo6WA-LBqofyffGE8D3QOx2i4bw2_sf20-xcpGg</recordid><startdate>20230801</startdate><enddate>20230801</enddate><creator>Rhee, Hyungjin</creator><creator>Lim, Hyun-Ji</creator><creator>Han, Kyunghwa</creator><creator>Yeom, Suk-Keu</creator><creator>Choi, Sang Hyun</creator><creator>Park, Ji Hoon</creator><creator>Cho, Eun-Suk</creator><creator>Park, Sumi</creator><creator>Lee, Mi-Jung</creator><creator>Choi, Gi Hong</creator><creator>Han, Dai Hoon</creator><creator>Lee, Seung Soo</creator><creator>Park, Mi-Suk</creator><general>Springer India</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>C1K</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6898-6617</orcidid><orcidid>https://orcid.org/0000-0003-2787-7876</orcidid><orcidid>https://orcid.org/0000-0001-7759-4458</orcidid><orcidid>https://orcid.org/0000-0002-5687-7237</orcidid><orcidid>https://orcid.org/0000-0002-3390-9793</orcidid><orcidid>https://orcid.org/0000-0002-1593-3773</orcidid><orcidid>https://orcid.org/0000-0001-5817-2444</orcidid><orcidid>https://orcid.org/0000-0002-5518-2249</orcidid><orcidid>https://orcid.org/0000-0002-6794-4909</orcidid><orcidid>https://orcid.org/0000-0001-5537-2360</orcidid><orcidid>https://orcid.org/0000-0003-3244-9171</orcidid></search><sort><creationdate>20230801</creationdate><title>A preoperative scoring system to predict lymph node metastasis in intrahepatic cholangiocarcinoma</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-3479eb11883d7ac5d6d5f2e7d9528494051470e0ec44c47e5cb34775f3fefe3b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Antigens</topic><topic>Bile ducts</topic><topic>Carcinoembryonic antigen</topic><topic>Cholangiocarcinoma</topic><topic>Colorectal Surgery</topic><topic>Hepatology</topic><topic>Lymph nodes</topic><topic>Lymphatic system</topic><topic>Magnetic resonance imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Original Article</topic><topic>Patients</topic><topic>Surgery</topic><topic>Training</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rhee, Hyungjin</creatorcontrib><creatorcontrib>Lim, Hyun-Ji</creatorcontrib><creatorcontrib>Han, Kyunghwa</creatorcontrib><creatorcontrib>Yeom, Suk-Keu</creatorcontrib><creatorcontrib>Choi, Sang Hyun</creatorcontrib><creatorcontrib>Park, Ji Hoon</creatorcontrib><creatorcontrib>Cho, Eun-Suk</creatorcontrib><creatorcontrib>Park, Sumi</creatorcontrib><creatorcontrib>Lee, Mi-Jung</creatorcontrib><creatorcontrib>Choi, Gi Hong</creatorcontrib><creatorcontrib>Han, Dai Hoon</creatorcontrib><creatorcontrib>Lee, Seung Soo</creatorcontrib><creatorcontrib>Park, Mi-Suk</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Hepatology international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rhee, Hyungjin</au><au>Lim, Hyun-Ji</au><au>Han, Kyunghwa</au><au>Yeom, Suk-Keu</au><au>Choi, Sang Hyun</au><au>Park, Ji Hoon</au><au>Cho, Eun-Suk</au><au>Park, Sumi</au><au>Lee, Mi-Jung</au><au>Choi, Gi Hong</au><au>Han, Dai Hoon</au><au>Lee, Seung Soo</au><au>Park, Mi-Suk</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A preoperative scoring system to predict lymph node metastasis in intrahepatic cholangiocarcinoma</atitle><jtitle>Hepatology international</jtitle><stitle>Hepatol Int</stitle><addtitle>Hepatol Int</addtitle><date>2023-08-01</date><risdate>2023</risdate><volume>17</volume><issue>4</issue><spage>942</spage><epage>953</epage><pages>942-953</pages><issn>1936-0533</issn><eissn>1936-0541</eissn><abstract>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
< 0.001) and validation (
p
= 0.010) cohorts and clinical LNM in test cohort (
p
< 0.001). The preoperative LNM score outperformed MRI-suspicious LN alone in predicting pathologic LNM (area under the curve, 0.703 vs. 0.604,
p
= 0.004). The preoperative LNM score was also associated with overall survival in all cohorts (
p
< 0.001).
Conclusions
Our preoperative LNM score was significantly associated with pathologic or clinical LNM and outperformed MRI-suspicious LN alone.</abstract><cop>New Delhi</cop><pub>Springer India</pub><pmid>36689090</pmid><doi>10.1007/s12072-022-10477-7</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-6898-6617</orcidid><orcidid>https://orcid.org/0000-0003-2787-7876</orcidid><orcidid>https://orcid.org/0000-0001-7759-4458</orcidid><orcidid>https://orcid.org/0000-0002-5687-7237</orcidid><orcidid>https://orcid.org/0000-0002-3390-9793</orcidid><orcidid>https://orcid.org/0000-0002-1593-3773</orcidid><orcidid>https://orcid.org/0000-0001-5817-2444</orcidid><orcidid>https://orcid.org/0000-0002-5518-2249</orcidid><orcidid>https://orcid.org/0000-0002-6794-4909</orcidid><orcidid>https://orcid.org/0000-0001-5537-2360</orcidid><orcidid>https://orcid.org/0000-0003-3244-9171</orcidid></addata></record> |
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| 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 |
| title | A preoperative scoring system to predict lymph node metastasis in intrahepatic cholangiocarcinoma |
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