Impact of histologically confirmed lymph node metastases on patient survival after surgical resection for hepatocellular carcinoma: Report of a Japanese nationwide survey

Kiyoshi Hasegawa, Masatoshi Makuuchi, Norihiro Kokudo, Namiki Izumi, Takafumi Ichida, Masatoshi Kudo, Yonson Ku, Michiie Sakamoto, Osamu Nakashima, Osamu Matsui, Yutaka Matsuyama

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

OBJECTIVE: To clarify the clinical significance of resection of lymph node metastases in patients' hepatocellular carcinoma (HCC). BACKGROUND: Although the presence of lymph node metastasis form HCC has been considered as a systemic disease, prognosis after resection of them remains unknown. METHODS: From the database of a Japanese nationwide survey, 14,872 patients of HCC treated by surgical resection between 2000 and 2005 were enrolled. We modified the current Japanese staging system for HCC, by further dividing stage IVA into stage IVAnon-n1 and stage n1, according to the absence or presence of pathologically proven lymph node metastasis. Thus, the patients classified into 6 disease stages, that is, I (n = 1494), II (n = 8056), III (n = 4243), IVAnon-n1 (n = 701), n1 (n = 112), and IVB (n = 266), and their long-term outcomes were compared. RESULTS: The median follow-up period was 20.6 months. The 3-year overall survival rates of the patients with stage IVAnon-n1, stage n1, and stage IVB were 51.6%, 38.9% and 27.2%, respectively. A multivariate analysis showed that stage IVAnon-n1 would have a similar impact on the survival as stage n1 (hazard ratio: 0.88, 95% confidence interval: 0.59-1.33, P = 0.555), and that stage n1 still represented one class less advanced than stage IVB (hazard ratio: 0.52, 95% confidence interval: 0.34-0.80, P = 0.003). CONCLUSIONS: The prognosis of patients with histologically node-positive HCC was similar to that of patients with locally advanced HCC (stage IVA), which supports the validity of the current Japanese staging system and also partially validates the system proposed by the UICC/AJCC.

Original languageEnglish
Pages (from-to)166-170
Number of pages5
JournalAnnals of Surgery
Volume259
Issue number1
DOIs
Publication statusPublished - 2014 Jan

Fingerprint

Hepatocellular Carcinoma
Lymph Nodes
Neoplasm Metastasis
Survival
Confidence Intervals
Surveys and Questionnaires
Multivariate Analysis
Survival Rate
Databases

Keywords

  • Hepatocellular carcinoma
  • Lymph node metastasis
  • The UICC/AJCC staging system

ASJC Scopus subject areas

  • Surgery

Cite this

Impact of histologically confirmed lymph node metastases on patient survival after surgical resection for hepatocellular carcinoma : Report of a Japanese nationwide survey. / Hasegawa, Kiyoshi; Makuuchi, Masatoshi; Kokudo, Norihiro; Izumi, Namiki; Ichida, Takafumi; Kudo, Masatoshi; Ku, Yonson; Sakamoto, Michiie; Nakashima, Osamu; Matsui, Osamu; Matsuyama, Yutaka.

In: Annals of Surgery, Vol. 259, No. 1, 01.2014, p. 166-170.

Research output: Contribution to journalArticle

Hasegawa, Kiyoshi ; Makuuchi, Masatoshi ; Kokudo, Norihiro ; Izumi, Namiki ; Ichida, Takafumi ; Kudo, Masatoshi ; Ku, Yonson ; Sakamoto, Michiie ; Nakashima, Osamu ; Matsui, Osamu ; Matsuyama, Yutaka. / Impact of histologically confirmed lymph node metastases on patient survival after surgical resection for hepatocellular carcinoma : Report of a Japanese nationwide survey. In: Annals of Surgery. 2014 ; Vol. 259, No. 1. pp. 166-170.
@article{96cdd97f3bc94ce0a715850d9ebebf5d,
title = "Impact of histologically confirmed lymph node metastases on patient survival after surgical resection for hepatocellular carcinoma: Report of a Japanese nationwide survey",
abstract = "OBJECTIVE: To clarify the clinical significance of resection of lymph node metastases in patients' hepatocellular carcinoma (HCC). BACKGROUND: Although the presence of lymph node metastasis form HCC has been considered as a systemic disease, prognosis after resection of them remains unknown. METHODS: From the database of a Japanese nationwide survey, 14,872 patients of HCC treated by surgical resection between 2000 and 2005 were enrolled. We modified the current Japanese staging system for HCC, by further dividing stage IVA into stage IVAnon-n1 and stage n1, according to the absence or presence of pathologically proven lymph node metastasis. Thus, the patients classified into 6 disease stages, that is, I (n = 1494), II (n = 8056), III (n = 4243), IVAnon-n1 (n = 701), n1 (n = 112), and IVB (n = 266), and their long-term outcomes were compared. RESULTS: The median follow-up period was 20.6 months. The 3-year overall survival rates of the patients with stage IVAnon-n1, stage n1, and stage IVB were 51.6{\%}, 38.9{\%} and 27.2{\%}, respectively. A multivariate analysis showed that stage IVAnon-n1 would have a similar impact on the survival as stage n1 (hazard ratio: 0.88, 95{\%} confidence interval: 0.59-1.33, P = 0.555), and that stage n1 still represented one class less advanced than stage IVB (hazard ratio: 0.52, 95{\%} confidence interval: 0.34-0.80, P = 0.003). CONCLUSIONS: The prognosis of patients with histologically node-positive HCC was similar to that of patients with locally advanced HCC (stage IVA), which supports the validity of the current Japanese staging system and also partially validates the system proposed by the UICC/AJCC.",
keywords = "Hepatocellular carcinoma, Lymph node metastasis, The UICC/AJCC staging system",
author = "Kiyoshi Hasegawa and Masatoshi Makuuchi and Norihiro Kokudo and Namiki Izumi and Takafumi Ichida and Masatoshi Kudo and Yonson Ku and Michiie Sakamoto and Osamu Nakashima and Osamu Matsui and Yutaka Matsuyama",
year = "2014",
month = "1",
doi = "10.1097/SLA.0b013e31828d4960",
language = "English",
volume = "259",
pages = "166--170",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Impact of histologically confirmed lymph node metastases on patient survival after surgical resection for hepatocellular carcinoma

T2 - Report of a Japanese nationwide survey

AU - Hasegawa, Kiyoshi

AU - Makuuchi, Masatoshi

AU - Kokudo, Norihiro

AU - Izumi, Namiki

AU - Ichida, Takafumi

AU - Kudo, Masatoshi

AU - Ku, Yonson

AU - Sakamoto, Michiie

AU - Nakashima, Osamu

AU - Matsui, Osamu

AU - Matsuyama, Yutaka

PY - 2014/1

Y1 - 2014/1

N2 - OBJECTIVE: To clarify the clinical significance of resection of lymph node metastases in patients' hepatocellular carcinoma (HCC). BACKGROUND: Although the presence of lymph node metastasis form HCC has been considered as a systemic disease, prognosis after resection of them remains unknown. METHODS: From the database of a Japanese nationwide survey, 14,872 patients of HCC treated by surgical resection between 2000 and 2005 were enrolled. We modified the current Japanese staging system for HCC, by further dividing stage IVA into stage IVAnon-n1 and stage n1, according to the absence or presence of pathologically proven lymph node metastasis. Thus, the patients classified into 6 disease stages, that is, I (n = 1494), II (n = 8056), III (n = 4243), IVAnon-n1 (n = 701), n1 (n = 112), and IVB (n = 266), and their long-term outcomes were compared. RESULTS: The median follow-up period was 20.6 months. The 3-year overall survival rates of the patients with stage IVAnon-n1, stage n1, and stage IVB were 51.6%, 38.9% and 27.2%, respectively. A multivariate analysis showed that stage IVAnon-n1 would have a similar impact on the survival as stage n1 (hazard ratio: 0.88, 95% confidence interval: 0.59-1.33, P = 0.555), and that stage n1 still represented one class less advanced than stage IVB (hazard ratio: 0.52, 95% confidence interval: 0.34-0.80, P = 0.003). CONCLUSIONS: The prognosis of patients with histologically node-positive HCC was similar to that of patients with locally advanced HCC (stage IVA), which supports the validity of the current Japanese staging system and also partially validates the system proposed by the UICC/AJCC.

AB - OBJECTIVE: To clarify the clinical significance of resection of lymph node metastases in patients' hepatocellular carcinoma (HCC). BACKGROUND: Although the presence of lymph node metastasis form HCC has been considered as a systemic disease, prognosis after resection of them remains unknown. METHODS: From the database of a Japanese nationwide survey, 14,872 patients of HCC treated by surgical resection between 2000 and 2005 were enrolled. We modified the current Japanese staging system for HCC, by further dividing stage IVA into stage IVAnon-n1 and stage n1, according to the absence or presence of pathologically proven lymph node metastasis. Thus, the patients classified into 6 disease stages, that is, I (n = 1494), II (n = 8056), III (n = 4243), IVAnon-n1 (n = 701), n1 (n = 112), and IVB (n = 266), and their long-term outcomes were compared. RESULTS: The median follow-up period was 20.6 months. The 3-year overall survival rates of the patients with stage IVAnon-n1, stage n1, and stage IVB were 51.6%, 38.9% and 27.2%, respectively. A multivariate analysis showed that stage IVAnon-n1 would have a similar impact on the survival as stage n1 (hazard ratio: 0.88, 95% confidence interval: 0.59-1.33, P = 0.555), and that stage n1 still represented one class less advanced than stage IVB (hazard ratio: 0.52, 95% confidence interval: 0.34-0.80, P = 0.003). CONCLUSIONS: The prognosis of patients with histologically node-positive HCC was similar to that of patients with locally advanced HCC (stage IVA), which supports the validity of the current Japanese staging system and also partially validates the system proposed by the UICC/AJCC.

KW - Hepatocellular carcinoma

KW - Lymph node metastasis

KW - The UICC/AJCC staging system

UR - http://www.scopus.com/inward/record.url?scp=84891631202&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84891631202&partnerID=8YFLogxK

U2 - 10.1097/SLA.0b013e31828d4960

DO - 10.1097/SLA.0b013e31828d4960

M3 - Article

C2 - 23532111

AN - SCOPUS:84891631202

VL - 259

SP - 166

EP - 170

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 1

ER -