Detailed Abstract
[Plenary - Biliary Disease/Surgery]
[PL 3] Proposal on the minimal number of retrieved lymph nodes for accurate staging of bile duct cancer
Jae Seung KANG1, Ryota HIGUCHI2, Jin HE3, Masakazu YAMAMOTO2, Christopher L. WOLFGANG3, John L. CAMERON3, Youngmin HAN1, Youngkang KIM4, Seungyeon LEE5, Taesung PARK4, Wooil KWON1, Sun-Whe KIM1, Jin-Young JANG1
1Surgery and Cancer Research Institute, Seoul National University College of Medicine, Korea
2Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Japan
3Surgery, Johns Hopkins University School of Medicine, USA
4Statistics, Seoul National University, Korea
5Mathematics and Statistics, Sejong University, Korea, Korea
Introduction : The three-tier N staging system of the 8th edition of the American Joint Committee on Cancer (AJCC) for extrahepatic bile duct (EBD) cancer is yet to be validated. The minimal number of retrieved lymph nodes (MNRLN) for accurate staging remains unclear. The present study aimed to propose the MNRLN, to validate the three-tier N staging system, and compare the prognostic predictability of 8th N staging with that of the 7th.
Methods : Between 1991 and 2015, patients with pathologically confirmed EBD adenocarcinoma who underwent curative-intent pancreatoduodenectomy in Seoul National University Hospital, Tokyo Women’s Medical University, and Johns Hopkins Medical Institute were enrolled in this study. The MNRLN was calculated via log-rank test based on cut-off values. The concordance index (C-index) was utilized to compare the discrimination capability of the two- and three-tier N staging.
Results : A total of 789 consecutive patients were enrolled. The survival rate was significantly different between node-negative and -positive patients in whom at least 10 lymph nodes were retrieved. The five-year overall survival rates between each 8th N stage was significantly different (N0 vs N1, P
Conclusions : For accurate stratification, at least 10 lymph nodes should be retrieved. The new three-tier system for N staging of EBD cancer is valid and has more accurate prognostic predictability than the 7th stage.
Methods : Between 1991 and 2015, patients with pathologically confirmed EBD adenocarcinoma who underwent curative-intent pancreatoduodenectomy in Seoul National University Hospital, Tokyo Women’s Medical University, and Johns Hopkins Medical Institute were enrolled in this study. The MNRLN was calculated via log-rank test based on cut-off values. The concordance index (C-index) was utilized to compare the discrimination capability of the two- and three-tier N staging.
Results : A total of 789 consecutive patients were enrolled. The survival rate was significantly different between node-negative and -positive patients in whom at least 10 lymph nodes were retrieved. The five-year overall survival rates between each 8th N stage was significantly different (N0 vs N1, P
Conclusions : For accurate stratification, at least 10 lymph nodes should be retrieved. The new three-tier system for N staging of EBD cancer is valid and has more accurate prognostic predictability than the 7th stage.
SESSION
Plenary
Room A 3/31/2018 11:00 AM - 11:50 AM