The optimal number of examined lymph nodes for cancer specific death of intrahepatic cholangiocarcinoma: a population-based study

Abstract Background The number of lymph nodes to be removed during tumor resection in patients with intrahepatic cholangiocarcinoma (ICC) has always been a subject of controversy. The correlation between examined lymph nodes (ELN) and cancer-specific mortality (CSM) in individuals with ICC was the p...

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Main Authors: Chaojia Ou, Yufan Zhou, You Tang, Zhiguo Tan, Chuang Peng, Xu Chen, Ou Li
Format: Article
Language:English
Published: Springer 2025-04-01
Series:Discover Oncology
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Online Access:https://doi.org/10.1007/s12672-025-02322-8
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author Chaojia Ou
Yufan Zhou
You Tang
Zhiguo Tan
Chuang Peng
Xu Chen
Ou Li
author_facet Chaojia Ou
Yufan Zhou
You Tang
Zhiguo Tan
Chuang Peng
Xu Chen
Ou Li
author_sort Chaojia Ou
collection DOAJ
description Abstract Background The number of lymph nodes to be removed during tumor resection in patients with intrahepatic cholangiocarcinoma (ICC) has always been a subject of controversy. The correlation between examined lymph nodes (ELN) and cancer-specific mortality (CSM) in individuals with ICC was the purpose of this investigation. Methods Multivariable models were used to analyze data from the Surveillance, Epidemiology, and End Results database on ICC in order to ascertain the connection between ELN count and CSM. Correlation between ELN and cancer-specific survival (CSS) was evaluated by restricted cubic splines (RCS) on a continuous scale. Locally weighted scatterplot smoothing smoother was used to evaluated the hazard ratios (HRs) of ELNs for CSS with the structural breakpoints determined by Chow test. Results This investigation incorporated 1335 ICC cases. Independent risk factors for CSM included median household income, race, diagnostic year, tumor grade, clinical stage, pT stage, pN stage, pM stage and ELN count. With the adjustment for covariates, ICC cases showed statistically significant improvements in CSS (HR = 0.88) as the ELN count increased. The best threshold ELN count, as determined by cut-point analysis, was 6, which allowed for accurate CSS probability discrimination. Conclusion Increasing ELN count indicated better CSS. Our results strongly suggested 6 ELNs as the optimal cut-off number for assessing the standard of lymph node inspection and prognostic classification in ICC.
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spelling doaj-art-0dc73259f0904b1e87fbf9da1775df7e2025-08-20T02:17:50ZengSpringerDiscover Oncology2730-60112025-04-0116111010.1007/s12672-025-02322-8The optimal number of examined lymph nodes for cancer specific death of intrahepatic cholangiocarcinoma: a population-based studyChaojia Ou0Yufan Zhou1You Tang2Zhiguo Tan3Chuang Peng4Xu Chen5Ou Li6Department of Hepatobiliary Surgery, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal UniversityDepartment of General Surgery, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal UniversityDepartment of Hepatobiliary Surgery, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal UniversityThe First School of Clinical Medicine, Lanzhou UniversityDepartment of Hepatobiliary Surgery, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal UniversityDepartment of Hepatobiliary Surgery, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal UniversityDepartment of Hepatobiliary Surgery, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal UniversityAbstract Background The number of lymph nodes to be removed during tumor resection in patients with intrahepatic cholangiocarcinoma (ICC) has always been a subject of controversy. The correlation between examined lymph nodes (ELN) and cancer-specific mortality (CSM) in individuals with ICC was the purpose of this investigation. Methods Multivariable models were used to analyze data from the Surveillance, Epidemiology, and End Results database on ICC in order to ascertain the connection between ELN count and CSM. Correlation between ELN and cancer-specific survival (CSS) was evaluated by restricted cubic splines (RCS) on a continuous scale. Locally weighted scatterplot smoothing smoother was used to evaluated the hazard ratios (HRs) of ELNs for CSS with the structural breakpoints determined by Chow test. Results This investigation incorporated 1335 ICC cases. Independent risk factors for CSM included median household income, race, diagnostic year, tumor grade, clinical stage, pT stage, pN stage, pM stage and ELN count. With the adjustment for covariates, ICC cases showed statistically significant improvements in CSS (HR = 0.88) as the ELN count increased. The best threshold ELN count, as determined by cut-point analysis, was 6, which allowed for accurate CSS probability discrimination. Conclusion Increasing ELN count indicated better CSS. Our results strongly suggested 6 ELNs as the optimal cut-off number for assessing the standard of lymph node inspection and prognostic classification in ICC.https://doi.org/10.1007/s12672-025-02322-8Intrahepatic cholangiocarcinomaLymph nodesCancer-specific deathSeer
spellingShingle Chaojia Ou
Yufan Zhou
You Tang
Zhiguo Tan
Chuang Peng
Xu Chen
Ou Li
The optimal number of examined lymph nodes for cancer specific death of intrahepatic cholangiocarcinoma: a population-based study
Discover Oncology
Intrahepatic cholangiocarcinoma
Lymph nodes
Cancer-specific death
Seer
title The optimal number of examined lymph nodes for cancer specific death of intrahepatic cholangiocarcinoma: a population-based study
title_full The optimal number of examined lymph nodes for cancer specific death of intrahepatic cholangiocarcinoma: a population-based study
title_fullStr The optimal number of examined lymph nodes for cancer specific death of intrahepatic cholangiocarcinoma: a population-based study
title_full_unstemmed The optimal number of examined lymph nodes for cancer specific death of intrahepatic cholangiocarcinoma: a population-based study
title_short The optimal number of examined lymph nodes for cancer specific death of intrahepatic cholangiocarcinoma: a population-based study
title_sort optimal number of examined lymph nodes for cancer specific death of intrahepatic cholangiocarcinoma a population based study
topic Intrahepatic cholangiocarcinoma
Lymph nodes
Cancer-specific death
Seer
url https://doi.org/10.1007/s12672-025-02322-8
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