Significance of lymph node micrometastasis in pN0 hilar bile duct carcinoma

Aims: To examine micrometastasis in node-negative hilar bile duct carcinoma (HBDC) using an immumohistochemical method and evaluated the clinical significance. Methods: Four hundred and twenty three regional lymph nodes from 28 patients with node-negative HBDC who had undergone a resection were immunostained with an antibody against cytokeratins eight and IS (CAM 5.2). Results: Lymph node micrometastasis was detected in I I of the 28 patients and 14 of the 423 lymph nodes. Lymph node micrometastasis was significantly correlated with the pT classification (p=0.03), the histopathological grading (p=0.01) and venous invasion (p=0.05). The 5-year survival rate of the patients with lymph node micrometastasis was 21.8%, as opposed to 66.5% in the patients without micrometastasis. Patients with micrometastasis showed a significantly poorer survival rate than those without micrometastasis (P=0.02). Conclusion: The results suggest that immunohistochemically detected lymph node micrometastasis has an impact on the outcome in HBDC. (c) 2005 Elsevier Ltd. All rights reserved.