Effect of lymph node metastasis and hepatic hilar lymph node dissection on prognosis of liver cancer patients: a Meta-analysis

doi:10.3877/cma.j.issn.2095-3232.2022.02.010

Abstract

Abstract:

Objective

To systematically evaluate the effect of lymph node metastasis and hepatic hilar lymph node dissection on the prognosis of patients with primary liver cancer (PLC).

Methods

Relevant studies of the effect of lymph node metastasis and hepatic hilar lymph node dissection on the prognosis were searched on the PubMed and CNKI. The retrieval time started from the inception of databases to April 30, 2020. The search terms included primary liver cancer, hepatocellular carcinoma, surgery, resectable, hepatectomy, liver resection, lymph node metastasis, partial, lymphadenectomy, prognosis, survival both in Chinese and English. The data of lymph node metastasis, hepatic hilar lymph node dissection and overall survival were extracted for Meta-analysis.

Results

10 relevant studies consisting of 1 278 cases were included. The result of Meta-analysis revealed that the overall survival of PLC patients with lymph node metastasis was relatively poor (HR=0.44, 95%CI: 0.29-0.65, P<0.001). The overall survival of PLC patients undergoing hepatic hilar lymph node dissection was significantly better than that of patients without hepatic hilar lymph node dissection (HR=0.59, 95%CI: 0.37-0.94, P=0.025). Funnel plot revealed no significant publication bias in this study. Sensitivity analysis indicated that the results were stable.

Conclusions

The overall survival of PLC patients with lymph node metastasis is relatively poor. Intraoperative hepatic hilar lymph node dissection can improve the prognosis of PLC patients.

Key words: Liver neoplasms, Lymphatic metastasis, Lymph node excision, Prognosis, Meta-analysis

Xueqiao Hu, Jiarui Yang, Wenguang Peng, Chusi Wang, Lei Zhang, Weidong Pan. Effect of lymph node metastasis and hepatic hilar lymph node dissection on prognosis of liver cancer patients: a Meta-analysis[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2022, 11(02): 159-163.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhgzwkssxdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3232.2022.02.010

https://zhgzwkssxdzzz.cma-cmc.com.cn/EN/Y2022/V11/I02/159

Figures/Tables 3

References 21

[1]	Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6):394-424.
[2]	Villanueva A. Hepatocellular carcinoma[J]. N Engl J Med, 2019, 380(15):1450-1462.
[3]	Rankin EB, Giaccia AJ. Hypoxic control of metastasis[J]. Science, 2016, 352(6282):175-180.
[4]	Lee YT, Geer DA. Primary liver cancer:pattern of metastasis[J].J Surg Oncol, 1987, 36(1):26-31.
[5]	Olubuyide IO. Pattern of metastasis of primary liver cancer at autopsy: an African series[J]. Trop Gastroenterol, 1991, 12(2):67-72.
[6]	Uka K, Aikata H, Takaki S, et al. Clinical features and prognosis of patients with extrahepatic metastases from hepatocellular carcinoma[J]. World J Gastroenterol, 2007, 13(3):414-420.
[7]	Jiang XB, Ke C, Zhang GH, et al. Brain metastases from hepatocellular carcinoma: clinical features and prognostic factors[J]. BMC Cancer, 2012(12):49.
[8]	Bruix J, Gores GJ, Mazzaferro V. Hepatocellular carcinoma: clinical frontiers and perspectives[J]. Gut, 2014, 63(5):844-855.
[9]	Ercolani G, Grazi GL, Ravaioli M, et al. The role of lymphadenectomy for liver tumors: further considerations on the appropriateness of treatment strategy[J]. Ann Surg, 2004, 239(2):202-209.
[10]	Sun HC, Zhuang PY, Qin LX, et al. Incidence and prognostic values of lymph node metastasis in operable hepatocellular carcinoma and evaluation of routine complete lymphadenectomy[J]. J Surg Oncol, 2007, 96(1):37-45.
[11]	祁付珍，张平，顾殿华, 等. 肝门淋巴结清扫术在原发性肝癌治疗中的价值[J]. 实用癌症杂志, 2009, 24(3):267-269, 284.
[12]	Shen X, Li H, Wang F, et al. Clinical significance of lymph node metastasis in patients undergoing partial hepatectomy for hepatocellular carcinoma[J]. World J Surg, 2010, 34(5):1028-1033.
[13]	Ravaioli M, Ercolani G, Grazi GL, et al. Safety and prognostic role of regional lymphadenectomy for primary and metastatic liver tumors[J]. Updates Surg, 2010, 62(1):27-34.
[14]	Lee CW, Chan KM, Lee CF, et al. Hepatic resection for hepatocellular carcinoma with lymph node metastasis: clinicopathological analysis and survival outcome[J]. Asian J Surg, 2011, 34(2):53-62.
[15]	何勇勇，石洁，程树群. 原发性肝癌门静脉癌栓患者合并肝门淋巴结转移手术疗效的比较研究[J]. 中国微创外科杂志, 2012, 12(8):687-689.
[16]	闾少冬，杨广顺，杨宁. 原发性肝癌淋巴转移治疗方法的选择[J]. 中国普通外科杂志, 2013, 22(4):524-526.
[17]	沈杭，钱叶本. 淋巴结切除对肝癌合并淋巴结转移患者预后影响分析[J]. 肝胆外科杂志, 2016, 24(6):407-409.
[18]	朱海涛. 伴肝门淋巴结转移乙肝相关性肝细胞癌患者不同疗法生存差异分析[J]. 贵州医科大学学报, 2018, 43(6):667-669.
[19]	Mitchell JD, Mathisen DJ, Wright CD, et al. Resection for bronchogenic carcinoma involving the carina: long-term results and effect of nodal status on outcome[J]. J Thorac Cardiovasc Surg, 2001, 121(3):465-471.
[20]	Hsu CP, Chen CY, Hsia JY, et al. Prediction of prognosis by the extent of lymph node involvement in squamous cell carcinoma of the thoracic esophagus[J]. Eur J Cardiothorac Surg, 2001, 19(1):10-13.
[21]	Miyao N, Masumori N, Takahashi A, et al. Lymph node metastasis in patients with carcinomas of the renal pelvis and ureter[J]. Eur Urol, 1998, 33(2):180-185.

作者	发表年份（年）	研究类型	病例组（例）	对照组（例）	NOS评分（星）
Ercolani，等^[9]	2004	队列研究	17	086	8
Sun，等^[10]	2007	队列研究	26	913	8
祁付珍，等^[11]	2009	病例对照研究	18	095	7
Shen，等^[12]	2010	队列研究	39	484	8
Ravaioli，等^[13]	2010	队列研究	81	081	8
Lee，等^[14]	2011	病例对照研究	22	145	7
何勇勇，等^[15]	2012	病例对照研究	15	013	7
闾少冬，等^[16]	2013	病例对照研究	18	028	6
沈杭，等^[17]	2016	病例对照研究	30	030	6
朱海涛^[18]	2018	病例对照研究	17	015	6

作者	发表年份（年）	研究类型	病例组（例）	对照组（例）	NOS评分（星）
Ercolani，等^[9]	2004	队列研究	17	086	8
Sun，等^[10]	2007	队列研究	26	913	8
祁付珍，等^[11]	2009	病例对照研究	18	095	7
Shen，等^[12]	2010	队列研究	39	484	8
Ravaioli，等^[13]	2010	队列研究	81	081	8
Lee，等^[14]	2011	病例对照研究	22	145	7
何勇勇，等^[15]	2012	病例对照研究	15	013	7
闾少冬，等^[16]	2013	病例对照研究	18	028	6
沈杭，等^[17]	2016	病例对照研究	30	030	6
朱海涛^[18]	2018	病例对照研究	17	015	6

Please choose a citation manager

Content to export