区域淋巴结的定义和分类对于肝门区胆管癌而言并不标准化。本研究旨在澄清区域淋巴结清扫的合理范围，并阐明基于数量的区域淋巴结分类对于患者存活率的影响。回顾了136例接受手术治疗的肝门区胆管癌患者的数据，并计算了每个淋巴结组的转移率和转移的患者的生存率。肝十二指肠韧带区域的淋巴结组的转移率在3.7％至25.4％之间，对于有转移的患者，5年疾病特异性生存率为12.9％至33.3％。普通肝动脉（编号为8）和胰十二指肠上后组（编号为13a）淋巴结组的转移率分别为14.4％和11.2％，有转移的患者的5年疾病特异性生存率分别为16.7％和20.0％。当将这些淋巴结组定义为区域淋巴结时，pN0（n = 80）、pN1（1-3个阳性淋巴结，n = 38）和pN2（≥4个阳性淋巴结，n = 18）患者的5年疾病特异性生存率分别为61.4％、22.9％和17.6％（p＜0.001）。 pN分类与疾病特异性生存率独立相关（p＜0.001）。当仅将12号淋巴结组视为区域淋巴结时，pN分类未能在预后上将患者分层。应该将8号和13a号淋巴结组视为区域淋巴结，并进行清扫。基于数量的区域淋巴结分类可以在这种疾病的患者中实现预后分层。© 2023年外科肿瘤学会。

The definition and classification of regional nodes are not standardized for perihilar cholangiocarcinoma. This study aimed to clarify the rational extent of regional lymphadenectomy and to elucidate the impact of number-based regional nodal classification on survival of patients with this disease.Data of 136 patients with perihilar cholangiocarcinoma who underwent surgery were reviewed. The incidence of metastasis and the survival of patients with metastasis were calculated for each node group.The incidence of metastasis for the node groups in the hepatoduodenal ligament (denoted as no. 12) ranged from 3.7% to 25.4%, with 5-year disease-specific survival of 12.9% to 33.3% for patients with metastasis. The incidences of metastasis in the common hepatic artery (no. 8) and posterior superior pancreaticoduodenal (no. 13a) node groups were 14.4% and 11.2%, respectively, with 5-year disease-specific survival rates of 16.7% and 20.0% for the patients with metastasis. When these node groups were defined as regional nodes, the 5-year disease-specific survival rates for the patients with pN0 (n = 80), pN1 (1-3 positive nodes, n = 38), and pN2 (≥ 4 positive nodes, n = 18) were 61.4%, 22.9%, and 17.6%, respectively (p < 0.001). The pN classification was independently associated with disease-specific survival (p < 0.001). When only the no. 12 node groups were regarded as regional nodes, pN classification failed to stratify the patients prognostically.No. 8 and no. 13a node groups should be considered regional nodes in addition to no. 12 node groups and should be dissected. The number-based regional nodal classification allows patients with this disease to be stratified prognostically.© 2023. Society of Surgical Oncology.