Introduction: We aimed to investigate the significance of lymph node metastasis from hepatocellular carcinoma and the efficacy of local treatment. Methods : We included patients diagnosed with hepatocellular carcinoma with lymph node metastasis. The pattern of lymph node metastasis was evaluated based on imaging examinations and stratified by three locations: regional (group A), beyond regional intra-abdomen (group B), and extra-abdomen (group C) lymph node metastasis. Results: Among 14474 patients, 852 (5.8%) were identified as having lymph node metastasis. Regarding the location of presentation, group A showed the highest incidence, followed by groups B and C. The 1-year overall survival of patients was 31.7%. The survival significantly differed according to the location of lymph node metastasis. The 1-year overall survival rates were 39.8%, 25.5%, and 22.2% in groups A, B, and C, respectively. All patients underwent systemic treatment, with others receiving additional local treatment. Local treatment yielded superior overall survival compared with no local treatment. After propensity score matching, local treatment was associated with improved survival. Additionally, patients were stratified based on disease status at the time of diagnosis of lymph node metastasis: lymph node alone and combined extra-nodal metastasis. The survival benefits of local treatment were observed in both groups. Conclusions: Our findings demonstrated the clinical significance of lymph node metastasis from hepatocellular carcinoma, which was well discriminated according to location, favoring regional metastasis. In patients with hepatocellular carcinoma presenting lymph node metastasis, active application of local treatment for lymph node metastasis can improve oncologic outcomes.


中文翻译：

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局部治疗肝细胞癌淋巴结转移的疗效

简介：我们的目的是探讨肝细胞癌淋巴结转移的意义和局部治疗的效果。方法：我们纳入了诊断为肝细胞癌并伴有淋巴结转移的患者。根据影像学检查评估淋巴结转移模式，并按三个部位分层：区域（A组）、区域腹内以外（B组）和腹外（C组）淋巴结转移。结果：14474 例患者中，852 例（5.8%）被诊断为淋巴结转移。从发病部位来看，A组发病率最高，其次是B组和C组。患者的1年总生存率为31.7%。根据淋巴结转移的部位，生存率存在显着差异。A、B、C组的1年总生存率分别为39.8%、25.5%、22.2%。所有患者均接受全身治疗，其他患者接受额外的局部治疗。与不进行局部治疗相比，局部治疗的总体生存率更高。倾向评分匹配后，局部治疗与提高生存率相关。此外，根据诊断淋巴结转移时的疾病状态对患者进行分层：单纯淋巴结转移和联合淋巴结外转移。两组均观察到局部治疗的生存获益。结论：我们的研究结果证明了肝细胞癌淋巴结转移的临床意义，根据部位可以很好地区分，有利于区域转移。对于出现淋巴结转移的肝细胞癌患者，积极应用淋巴结转移的局部治疗可以改善肿瘤预后。