ヒグチ　リヨウタ   HIGUCHI Ryota   樋口　亮太    所属   医学部 医学科（附属八千代医療センター）    職種   講師
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Proposal of the minimal number of retrieved regional lymph nodes for accurate staging of distal bile duct cancer and clinical validation of the three-tier lymph node staging system (AJCC 8th edition).
掲載誌名	正式名：Journal of hepato-biliary-pancreatic sciences 略　 称：J Hepatobiliary Pancreat Sci ISSNコード：18686982/18686974
巻・号・頁	27(2),pp.75-83
著者・共著者	Kang Jae Seung, Higuchi Ryota, He Jin, Yamamoto Masakazu, Wolfgang Christopher L, Cameron John L, Han Youngmin, Son Donghee, Lee Seungyeon, Choi Yoo Jin, Byun Yoonhyeong, Kim Hongbeom, Kwon Wooil, Kim Sun-Whe, Park Taesung, Jang Jin-Young
担当区分	2nd著者
発行年月	2020/02
概要	BACKGROUND:The minimal required number of retrieved lymph nodes (MNRLNs) to enable accurate staging of distal bile duct (DBD) adenocarcinoma remains unclear. The three-tier 8th N staging system of the American Joint Committee on Cancer (AJCC) for DBD adenocarcinoma has been recently released. The present study is aimed at proposing the MNRLNs for accurate staging and validating the 8th N stage.METHODS:Between 1991 and 2015, patients with pathologically confirmed DBD adenocarcinoma who underwent pancreatoduodenectomy were enrolled. MNRLN was calculated via a log-rank test based on cut-off values. The concordance index (C-index) was utilized to compare the discrimination capability of the two- and three-tier N stages.RESULTS:A total of 780 patients were enrolled. Lymph node (LN) positivity and 5-year overall survival (5-YOS) rates stabilized and significant survival differences between node-negative and -positive patients were observed when ≥12 LNs were retrieved. 5-YOS rates between each 8th N stage significantly differ (N0 vs. N1, P = 0.037; N1 vs. N2, P = 0.003). The C-index of the 8th N stage was higher than that of the 7th (0.59 vs. 0.57).CONCLUSIONS:For accurate staging, at least 12 LNs should be retrieved. The three-tier N staging system is valid for clinical practice and has a more accurate prognostic predictability than the two-tier system.
DOI	10.1002/jhbp.690
PMID	31633308