Erschienen in:
13.05.2019 | ASO Author Reflections
ASO Author Reflections: Routine Lymphadenectomy Should be Recommended Regardless of Morphologic Subtype of Intrahepatic Cholangiocarcinoma
verfasst von:
Timothy M. Pawlik, MD, MPH, Ph.D.
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 7/2019
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Excerpt
Whether a routine lymphadenectomy should be performed at the time of surgical resection for intrahepatic cholangiocarcinoma (ICC) remains undetermined. Some authors advocate a routine lymphadenectomy as lymph node metastasis (LNM) cannot be accurately evaluated by preoperative imaging. Routine lymphadenectomy can help in staging nodal disease, informing adjuvant therapies, and potentially decreasing local recurrence.
1 In contrast, some clinicians only perform lymphadenectomy selectively.
2 Utilization of routine lymphadenectomy for ICC is increasing at major institutions worldwide.
1 Interestingly, some surgeons recommend omission of routine lymphadenectomy for mass-forming (MF) or intraductal growth (IG) subtype ICC, as these two ICC subtypes grow expansively like HCC or intraductally with perhaps a lower risk of lymphatic and perineural invasion, as well as a lower incidence of LNM.
3 In fact, different morphologic subtypes of ICC indicate different etiology, distinct cellular origin, and thus different disease progression and outcomes. …
