ABSTRACT
Objective:
To systematically
review the profile of
lymph node dissection (LND) for
patients with
intrahepatic cholangiocarcinoma (ICC) in
China.
Methods:
Using the key words "
intrahepatic cholangiocarcinoma" "intrahepatic
cholangiocellular carcinoma" "
lymph node dissection" "lymphadenec-tomy" "
lymph node metastasis", the databases including
China Zhiwang, Wanfang, Weipu, Sinomed,
PubMed, Embase, Web of
Science, Scopus, Cochrane
Library were systematically searched.
Cohort studies or randomized controlled clinical trials with intraoperative LND
documentation and with
analysis on the clinicopathologic characteristics or prognostic influences on
patients with ICC were included into this
meta-analysis from the date of database creation to April 20, 2022. The
risk of
bias in non-randomized controlled trials was evaluated using the Newcastle-Ottawa scale. A
meta-analysis of preoperative imaging
lymph node enlargement rates, LND rates, and pathological
lymph node metastasis rates were performed using R
software.
Results:
Thirty-three relevant studies that met the systematic evaluation criteria were included, all of which were retrospective
cohort studies. All these
publications were of medium to high quality.
Patients’ enrollment ranged from 1993 to 2020.
Patients were enrolled from 20 provinces/autonomous regions/municipalities with a total of 39 medical centers and 4 278
patients. The
meta-analysis indicated that the LND rate, preoperative imaging
lymph node enlargement rate, pathological
lymph node metastasis rate were 47.8%(95% CI 41.3%-54.3%), 18.5%(95% CI 7.5%-29.6%) and 51.2%(95% CI 43.8%-58.6%), respectively. Subgroup
analysis showed the LND rate was 36.0%(95% CI 27.0%-45.0%) in studies with a median year of enrollment before 2010, 48.3% (95% CI 38.1%-58.6%) in studies from 2010 to 2017, and 53.3%(95% CI 43.3%-63.2%) in studies after 2017. The LND rates were statistically different in the studies in the different periods of
patient enrollment ( P=0.032).
Conclusion:
The
meta-analysis indicated that the overall LND rate for ICC in
China was not high but showed an increasing tendency.