Abstract
Background
We compared the prognostic performance of the International Union Against Cancer/American
Joint Committee on Cancer (UICC/AJCC) 7th edition pN stage, number of metastatic LNs
(MLNs), LN ratio (LNR), and log odds of MLNs (LODDS) in patients with perihilar cholangiocarcinoma
(PCC) undergoing curative surgery in order to identify the best LN staging method.
Methods
Ninety-nine patients who underwent surgery with curative intent for PCC in a single
tertiary hepatobiliary referral center were included in the study. Two approaches
were used to evaluate and compare the predictive power of the different LN staging
methods: one based on the estimation of variable importance with prediction error
rate and the other based on the calculation of the receiver operating characteristic
(ROC) curve.
Results
LN dissection was performed in 92 (92.9%) patients; 49 were UICC/AJCC pN0 (49.5%),
33 pN1 (33.3%), and 10 pN2 (10.1%). The median number of LNs retrieved was 8. The
prediction error rate ranged from 42.7% for LODDS to 47.1% for UICC/AJCC pN stage.
Moreover, LODDS was the variable with the highest area under the ROC curve (AUC) for
prediction of 3-year survival (AUC = 0.71), followed by LNR (AUC = 0.60), number of
MLNs (AUC = 0.59), and UICC/AJCC pN stage (AUC = 0.54).
Conclusions
The number of MLNs, LNR, and LODDS appear to better predict survival than the UICC/AJCC
pN stage in patients undergoing curative surgery for PCC. Moreover, LODDS seems to
be the most accurate and predictive LN staging method.
Keywords
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Article info
Publication history
Published online: January 08, 2017
Accepted:
December 15,
2016
Identification
Copyright
© 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
