Hilar Cholangiocarcinoma: The Number of Positive Nodes and Positive Node/Total Node Ratio is a Significant Prognostic Factor for Survival §

Abstract Introduction Surgical treatment of hilar cholangiocarcinoma remains a challenge. Multiple prognostic factors have been proposed. The number of positive nodes and the ratio between positive lymph node and total lymph node (G+/Gt) are considered by some authors as the most important factor. Materials and methods We analysed a series of 58 patients with Klatskin tumours. We evaluated the prognostic factors and survival with emphasis on the prognostic impact of the number of positive nodes and its relation to total lymph nodes. Results Resectability was 78% with a 5-year survival of 32%. The median number of nodes examined was 9.5. No significant differences were found in several of the proposed prognostic factors. The presence of 2 or more positive nodes or a ratio G+/Gt≥0.2 were found to be poor prognostic factors. Conclusion The relationship between positive lymph nodes and total lymph nodes and the number of positive lymph nodes are important prognostic factors.