This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Jaeck, D. Articles by Chenard-Neu, M.-P. Search for Related Content PubMed PubMed Citation Articles by Jaeck, D. Articles by Chenard-Neu, M.-P. Related Collections Prognostic factors

Significance of Hepatic Pedicle Lymph Node Involvement in Patients With Colorectal Liver Metastases: A Prospective Study

From Centre de Chirurgie Viscérale et de Transplantation (DJ, HN, PB, KI, J-CW, EO, PW) and Service d’Anatomie Pathologique (M-PC-N), Hôpital de Hautepierre, Strasbourg, France.

Correspondence: Address correspondence and reprint requests to: Daniel Jaeck, MD, PhD, Centre de Chirurgie Viscérale et de Transplantation, Hôpital de Hautepierre, Avenue Molière, 67098 Strasbourg Cedex, France; Fax: 33-3-88-12-72-86; E-mail: daniel.jaeck{at}chru-strasbourg.fr

Background: We investigated whether hepatic pedicle lymph node (HP-LN) involvement is a more significant prognostic factor and whether HP-LN dissection could be efficient in patients with positive HP-LN involvement.

Methods: From 1988 to 1998, HP-LN dissection was prospectively performed in 160 patients undergoing hepatectomy for colorectal liver metastases. Survival of patients with HP-LN involvement limited to the hepatoduodenal ligament and retropancreatic portion (area 1) was compared with that of patients with HP-LN involvement spreading over the common hepatic artery and celiac axis (area 2).

Results: HP-LN involvement was detected in 17 patients. The survival rate was significantly lower in patients with HP-LN involvement. HP-LN involvement was the most significant prognostic factor. Survival was significantly higher in patients with HP-LN involvement limited to area 1 than in those with HP-LN involvement spreading over area 2.

Conclusions: HP-LN involvement was the most significant prognostic indicator in patients with colorectal liver metastases. Positive LNs of area 1 should no longer be considered an absolute contraindication to liver resection, but in case of area 2 lymph node involvement, liver resection does not seem justified.

Key Words: Hepatic pedicle lymph node involvement • Colorectal liver metastasis • Hepatic resection • Prognostic factors

This article has been cited by other articles:

				R. Adam, R. J. de Haas, D. A. Wicherts, T. A. Aloia, V. Delvart, D. Azoulay, H. Bismuth, and D. Castaing Is Hepatic Resection Justified After Chemotherapy in Patients With Colorectal Liver Metastases and Lymph Node Involvement? J. Clin. Oncol., August 1, 2008; 26(22): 3672 - 3680. [Abstract] [Full Text] [PDF]

				J. J. Bennett, C. R. Schmidt, D. S. Klimstra, S. R. Grobmyer, N. M. Ishill, M. D'Angelica, R. P. DeMatteo, Y. Fong, L. H. Blumgart, and W. R. Jarnagin Perihepatic Lymph Node Micrometastases Impact Outcome after Partial Hepatectomy for Colorectal Metastases Ann. Surg. Oncol., April 1, 2008; 15(4): 1130 - 1136. [Abstract] [Full Text] [PDF]

				T. M. Pawlik, R. D. Schulick, and M. A. Choti Expanding Criteria for Resectability of Colorectal Liver Metastases Oncologist, January 1, 2008; 13(1): 51 - 64. [Abstract] [Full Text] [PDF]

				D. Jaeck and E. Oussoultzoglou Intrahepatic Lymphatic Invasion Independently Predicts Poor Survival and recurrences after Hepatectomy in Patients with Colorectal Carcinoma Liver Metastases Ann. Surg. Oncol., December 1, 2007; 14(12): 3297 - 3298. [Full Text] [PDF]

				P. V. Korita, T. Wakai, Y. Shirai, J. Sakata, K. Takizawa, P. V. Cruz, Y. Ajioka, and K. Hatakeyama Intrahepatic Lymphatic Invasion Independently Predicts Poor Survival and Recurrences after Hepatectomy in Patients with Colorectal Carcinoma Liver Metastases Ann. Surg. Oncol., December 1, 2007; 14(12): 3472 - 3480. [Abstract] [Full Text] [PDF]

				M. Minagawa, J. Yamamoto, T. Kosuge, Y. Matsuyama, S.-i. Miyagawa, and M. Makuuchi Simplified Staging System for Predicting the Prognosis of Patients With Resectable Liver Metastasis: Development and Validation Arch Surg, March 1, 2007; 142(3): 269 - 276. [Abstract] [Full Text] [PDF]

				E. K. Abdalla, R. Adam, A. J. Bilchik, D. Jaeck, J.-N. Vauthey, and D. Mahvi Improving Resectability of Hepatic Colorectal Metastases: Expert Consensus Statement Ann. Surg. Oncol., October 1, 2006; 13(10): 1271 - 1280. [Full Text] [PDF]

				R. B. Adams, D. G. Haller, and M. S. Roh Improving Resectability of Hepatic Colorectal Metastases: Expert Consensus Statement By Abdalla et al. Ann. Surg. Oncol., October 1, 2006; 13(10): 1281 - 1283. [Full Text] [PDF]

				V. P. Khatri, N. J. Petrelli, and J. Belghiti Extending the Frontiers of Surgical Therapy for Hepatic Colorectal Metastases: Is There a Limit? J. Clin. Oncol., November 20, 2005; 23(33): 8490 - 8499. [Abstract] [Full Text] [PDF]

				D. Jaeck The Significance of Hepatic Pedicle Lymph Nodes Metastases in Surgical Management of Colorectal Liver Metastases and of Other Liver Malignancies Ann. Surg. Oncol., November 1, 2003; 10(9): 1007 - 1011. [Abstract] [Full Text] [PDF]

				M. S. Roh Should a Potentially Noncurative Resection that Prolongs Survival be Offered to Patients With Colorectal Liver Metastases? Ann. Surg. Oncol., June 1, 2002; 9(5): 423 - 424. [Full Text] [PDF]