Clinical Outcome of Surgical Management for Solitary Intrathoracic Lymph Node Metastasis from Hepatocellular Carcinoma
김동희, 이강훈, 복진산, 황수경, 최세훈, 김형렬, 김용희, 김동관, 박승일
울산대학교 의과대학 서울아산병원 흉부외과학교실
Background : The intrathoracic lymph node metastasis from hepatocellular carcinoma (HCC) is rare situation, so its treatment remained controversial. The aim of this study is to evaluate the efficacy of surgical treatment for intrathoracic lymph node metastasis from HCC.
Methods : 14 adult cases (median age 55 years, range 46-64 years; 13 males) who underwent surgical excision for solitary intrathoracic lymph node metastasis from April 2006 to March 2015 were evaluated retrospectively.
Results : There were no surgical complication and perioperative mortality. Video assisted thoracic surgery (VATS) was tried in 13 cases, and among these patients, 2 cases underwent conversion to thoracotomy approach. The involved location was mainly cardiophrenic lymph node in 9 cases, internal mammary lymph node in 2 cases, and other mediastinal lymph node such as paratracheal or paraesophageal node in 9 cases. In 4 cases, lymph node metastasis was found at the initial evaluation of HCC, other 10 patient was found during follow up periods after initial treatment. When subgroup was divided according to the timing of diagnosis with synchronous lymph node metastasis or metachronous metastasis, survival outcome was differed significantly between two groups (median survival 5.16 month ± 2.27 vs. 55.5 month ± 35.2, p<0.05, Figure 1). Other findings such as location of involved lymph nodes and number of lymph nodes showed no effects in mortality.
Conclusion : The results of this study indicate that the solitary lymph node metastasis that was found during follow up period, can be excised with promising surgical outcomes.

책임저자: 김동관
울산대학교 의과대학 서울아산병원 흉부외과학교실
연락처 : 김동희, Tel: 010-4402-3014 , E-mail : iclid@aol.com