The significance of hepatic pedicle lymph nodes metastases in surgical management of colorectal liver metastases and of other liver malignancies.

摘要: Background: Surgical resection of colorectal liver metastases (CLM) is the only hope for cure, with a 5-year survival rate ranging from 20% to 54%. However, resectability CLM reported be <20%. This limitation mainly due insufficient remnant and extrahepatic disease. Among locations, lymph node are often considered indications very poor prognosis contra-indication resection. Methods Results: Our studies showed that prevalence hepatic pedicle ranges 10% 20%. When located near hilum along (area 1) they should not an absolute CLM, extended lymphadenectomy performed. when reach celiac trunk 2), there no benefit after CLM. For other cases malignancies, dissection seems justified in fibrolamellar hepatocellular carcinoma case hilar cholangiocarcinoma. few data available, controversial. Conclusions: There need more evaluation involvement, at least patients high risk such extension, i.e., than three metastases, segment 4 or 5. also prospective trials order evaluate circumstances impact extensive lymphadenectomy.