Does the extent of lymphadenectomy, number of lymph nodes, positive lymph node ratio and neutrophil-lymphocyte ratio impact surgical outcome of perihilar cholangiocarcinoma?

Background Lymph node (LN) status is an important predictor of survival following resection of perihilar cholangiocarcinoma (PHCCA). Controversies still exist with regard to the prognostic value of optimum extent of lymphadenectomy, total number of nodes removed, LN ratio (LNR) and neutrophil–lymphocyte ratio (NLR) on overall survival (OS) and disease-free survival (DFS) following PHCCA resection. Methods From 1994 to 2010, 84 PHCCAs were resected; 78 are included in this analysis. Kaplan–Meier survival curves were studied using log-rank statistics to assess which variables affected OS and DFS. The variables that showed statistical significance (P Results Five-year OS for node-positive status (n=45) was 10%, whereas node-negative (n=33) OS was 41% (P Conclusion Extended lymphadenectomy patients (≥20 LNs) had worse OS when compared with those with more limited (