Hepatic Resection for Hepatocellular Carcinoma With Lymph Node Metastasis: Clinicopathological Analysis and Survival Outcome

Abstract

This study identified the worst prognosis of HCC in a population with LNM. HCC with LNM tends to be the infiltrating type with larger tumour size (> 5 cm), presence of microvascular invasion, and worse histological grade. Liver resection with lymphadenectomy is possibly beneficial for patients with HCC accompanied by LNM.

Cadherin 17 is related to recurrence and poor prognosis of cytokeratin 19‑positive hepatocellular carcinoma

“…In addition, CDH17 expression was associated with LNM and a likelihood of vascular invasion in HCC. Both LNM and vascular invasion were well known poor prognostic factors for DFS and OS after hepatectomy (11). Our study, as a result, agreed with previous reports that CDH17 expression was a poor prognostic factor for HCC after hepatectomy.…”

“…There have also been studies demonstrating that CK19 expression in primary HCC is a significant risk factor for developing lymph node metastasis (LNM) (4,7,8). Compared with other malignancies such as lung cancer, esophageal cancer, renal cancer, gastric cancer, and intra-hepatic cholangiocarcinoma, the incidence of LNM in primary HCC is low, and the prognosis is poor when LNM occurs (9)(10)(11). HCC with CK19 expression, subsequently, may be a special subtype of HCC with distinct clinical behavior from HCC without CK19 expression (8).…”

The expression of cytokeratin 19 in lymph nodes was a poor prognostic factor for hepatocellular carcinoma after hepatic resection

“…Compared with other malignancies such as lung cancer, esophageal cancer, renal cancer, gastric cancer, and intra-hepatic cholangiocarcinoma, the incidence of lymph node metastasis (LNM) in primary HCC is very low, and the prognosis is poor when LNM occurs [2-11]. Nevertheless, despite this poor outcome, previous study has documented that the 5-year overall survival rate of HCC with LNM after hepatectomy and lymph node dissection was 13.6%, and 5 out of 22 patients had survival of more than two years [12]. Due to LNM’s dismal role in prognosis, it is imperative to identify those patients at risk for LNM for more aggressive treatment and detailed examination.…”

Inferior vena cava tumor thrombus that directly infiltrated from paracaval lymph node metastases in a patient with recurrent hepatocellular carcinoma

“…Although the size of the HCC tumor during the first hepatectomy was less than 5 cm in the present case, histological examination showed that the HCC cells were giant atypical cells, including pleomorphic cells, and had spread to the surrounding normal liver tissue with no well-defined border and had invaded the portal vein. Our patient had chronic HBV infection, but Lee et al [12] concluded that neither HBV infection nor hepatitis C virus infection was related to the development of LN metastases.…”

“…Corresponding with the findings of the latter report, a microscopic examination of the resected LN metastases in our case showed poorly differentiated HCC, with proliferation in a trabecular or solid pattern. Lee et al [12] investigated the clinicopathological characteristics of HCC with LN metastases, and they concluded that having both an infiltrating type and a larger (>5 cm) tumor with microvascular invasion, as well as a high-grade histology were associated with higher incidences of LN metastases. Although the size of the HCC tumor during the first hepatectomy was less than 5 cm in the present case, histological examination showed that the HCC cells were giant atypical cells, including pleomorphic cells, and had spread to the surrounding normal liver tissue with no well-defined border and had invaded the portal vein.…”