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Management of lymph nodes during resection of hepatocellular carcinoma and intrahepatic cholangiocarcinoma: a systematic review.
[cholangiocarcinoma]
The
role
of
lymph
node
dissection
(
LND
)
in
the
treatment
of
patients
with
hepatocellular
carcinoma
(
HCC
)
or
intrahepatic
cholangiocarcinoma
(
ICC
)
remains
controversial
.
We
sought
to
systematically
review
all
available
evidence
to
determine
the
role
of
LND
in
patients
with
HCC
and
ICC
.
Studies
that
reported
on
LND
,
lymph
node
metastasis
(
LNM
)
,
and
short
-
and
long
-term
outcomes
for
patients
with
HCC
or
ICC
survival
were
identified
from
PubMed
,
Cochrane
,
Embase
,
Scopus
,
and
Web
of
Science
databases
.
Data
were
extracted
,
synthesized
,
and
analyzed
using
standard
techniques
.
A
total
of
603
and
434
references
were
identified
for
HCC
and
ICC
,
respectively
.
Among
HCC
patients
,
the
overall
prevalence
of
LND
was
51
.
6
%
(
95
%
confidence
interval
(
CI
)
19
.
7
-
83
.
5
)
with
an
associated
LNM
incidence
of
44
.
5
%
(
95
%
CI
27
.
4
-
61
.
7
)
.
LNM
was
associated
with
a
3
-
and
5
-
year
survival
of
27
.
5
and
20
.
8
Â
%
,
respectively
.
Among
ICC
patients
,
most
patients
78
.
5
Â
%
(
95
%
CI
76
.
2
-
80
.
7
)
underwent
LND
;
45
.
2
%
(
95
%
CI
39
.
2
-
51
.
2
)
had
LNM
.
Three
and
5
-
year
survival
among
ICC
patients
with
LNM
was
0
.
2
%
(
95
%
CI
0
-
0
.
7
)
and
0
%
,
respectively
.
While
there
are
insufficient
data
to
recommend
a
routine
LND
in
all
patients
with
HCC
or
ICC
,
the
potential
prognostic
value
of
LND
suggests
that
LND
should
at
least
be
considered
at
the
time
of
surgery
.
Diseases
Validation
Diseases presenting
"hepatocellular carcinoma"
symptom
cholangiocarcinoma
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal squamous cell carcinoma
primary hyperoxaluria type 1
severe combined immunodeficiency
werner syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated