The Role of Prophylactic Lymph Node Dissection in Patients with Intrahepatic Cholangiocarcinoma

Purpose: We investigated the role of prophylactic lymph node dissection (LND) in patients with intrahepatic cholangiocarcinoma (ICC). Methods: A retrospective analysis was performed evaluating the impact on survival of prophylactic LND and preoperative risk factors for histological lymph node metastasis (LNM) in a cohort of 49 patients with ICC of the mass-forming type, who underwent curative resection between 1995 and 2013. Results: There were no differences in both disease-free survival (DFS) and overall survival (OS) between the patients without LND and the patients with LND who did not have LNM. Multivariate analysis revealed that serum CA19-9 level > 150 U/mL and LN size > 5 mm on preoperative computed tomography (CT) were the significant preoperative risk factors for LNM. None of the patients with LN size < 5 mm on preoperative CT and serum CA19-9 level ? 150 U/mL had LNM. Conclusions: Prophylactic LND did not significantly improve DFS or OS in the present study. Regional LND could be omitted for patients with LN size < 5 mm in preoperative CT and serum CA19-9 level ? 150 U/ mL who are unlikely to have LNM.