• Jian-Wei Zhang, Yun-Mian Chu, Zhong-Min Lan, Xiao-Long Tang, Ying-Tai Chen, Cheng-Feng Wang, and Xu Che.
• Jian-Wei Zhang, Yun-Mian Chu, Zhong-Min Lan, Xiao-Long Tang, Ying-Tai Chen, Cheng-Feng Wang, Xu Che, Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
• World J. Gastroenterol. 2015 Apr 14; 21 (14): 4255-60.

AimTo investigate the prognostic value of metastatic lymph node ratio (MLNR) in extrahepatic cholangiocarcinoma (ECC) patients undergoing radical resection.MethodsSeventy-eight patients with ECC were enrolled. Associations between various clinicopathologic factors and prognosis were investigated by Kaplan-Meier analyses. The Cox proportional-hazards model was used for multivariate survival analysis.ResultsThe overall three- and five-year survival rates were 47.26% and 23.99%, respectively. MLNR of 0, 0-0.2, 0.2-0.5, and > 0.5 corresponded to five-year survival rates of 28.59%, 21.60%, 18.84%, and 10.03%, respectively. Univariate analysis showed that degree of tumor differentiation, lymph node metastasis, MLNR, tumor-node-metastasis (TNM) stage, and margin status were closely associated with postoperative survival in ECC patients (P < 0.05). Multivariate analysis showed that MLNR and TNM stage were independent prognostic factors after pancreaticoduodenectomy (HR = 2.13, 95%CI: 1.45-3.11; P < 0.01; and HR = 1.97, 95%CI: 1.17-3.31; P = 0.01, respectively). The median survival time for MLNR > 0.5, 0.2-0.5, 0-0.2, and 0 was 15 mo, 24 mo, 23 mo, and 35.5 mo, respectively. There were statistical differences in survival time between patients with different MLNR (χ(2) = 15.38; P < 0.01).ConclusionMLNR is an independent prognostic factor for ECC patients after radical resection and is useful for predicting postoperative survival.

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