Abstract
Lymph node involvement is an important prognostic factor in intrahepatic cholangiocarcinoma. Besides the nodes in the hepatoduodenal ligament, recent studies have suggested that the nodes around the cardiac portion of the stomach or along the gastric lesser curvature can be affected when the primary tumor is located in the left hepatic lobe. However, the distribution of metastatic nodes has not been well described in this disease. Thirteen patients with intrahepatic cholangiocarcinoma in the left hepatic lobe were enrolled in this study. Lymphatic mapping was performed by means of both histologic examination and reverse transcriptase-polymerase chain reaction assays. Nodal involvement around the cardiac portion of the stomach or along the lesser gastric curvature (left pathway) was found in 7 (54%) of 13 patients by histologic examination or reverse transcriptase-polymerase chain reaction, whereas positive nodes in the hepatoduodenal ligament (right pathway) were found in 6 (46%) of 13 patients. Two patients (15%) had positive nodes only in the left pathway. Therefore, for a more accurate clinical staging of intrahepatic cholangiocarcinoma in the hepatic left lobe, lymph nodes around the cardiac portion of the stomach and along the lesser gastric curvature should be examined in addition to nodes in the hepatoduodenal ligament.
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Supported by a grant from the Osaka Anti-Cancer Association; by grants-in-aid from the Second Term Comprehensive 10-year Strategy for Cancer Control (H12-Cancer-020) and Cancer Research of the Ministry of Health and Welfare, Japan; by grants-in-aid from the Scientific Research on Priority Areas and Basic Research of the Ministry of Education, Science, Sports, and Culture, Japan; and by a grant from the Osaka Medical Research Foundation for Incurable Disease.
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Okami, J., Dono, K., Sakon, M. et al. Patterns of regional lymph node involvement in intrahepatic cholangiocarcinoma of the left lobe. Journal of Gastrointestinal Surgery 7, 850–856 (2003). https://doi.org/10.1007/s11605-003-0029-5
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DOI: https://doi.org/10.1007/s11605-003-0029-5