Predictors of survival after surgery with curative intent for perihilar cholangiocarcinoma

World Journal of Surgical Oncology

Baki Topal¹  Joris Jaekers¹  Joachim Geers¹  Halit Topal¹  Raymond Aerts¹  Cindy Vandoren²  Guy Vanden Boer² 

[1] Department of Visceral Surgery, University Hospitals KU Leuven, Herestraat 49, 3000, Leuven, Belgium;Management Information & Registration, University Hospitals KU Leuven, Herestraat 49, 3000, Leuven, Belgium;

关键词: Biliary tract cancer;    Liver resection;    Perihilar cholangiocarcinoma;    Survival;    Prognostic factors;   

DOI  :  10.1186/s12957-020-02060-x

来源: Springer

【 摘 要 】

BackgroundSeveral clinicopathological predictors of survival after curative surgery for perihilar cholangiocarcinoma (pCCA) have been identified; however, conflicting reports remain. The aim was to analyse clinical and oncological outcomes after curative resection of pCCA and to determine prognostic factors.MethodsEighty-eight consecutive patients with pCCA underwent surgery with curative intent between 1998 and 2017. Survival curves were estimated using the Kaplan-Meier method and compared using the log-rank test. Twenty-one prognostic factors were evaluated using multivariate Cox regression models.ResultsPostoperative complications were observed in 73 (83%) patients of which 41 (47%) were severe complications (therapy-oriented severity grading system (TOSGS) grade > 2), including a 90-day mortality of 9% (n = 8). Overall survival (OS) and disease-free survival (DFS) rates at 5 and 10 years after surgery were 33% and 19%, and 37% and 30%, respectively. Independent predictors of OS were locoregional lymph node metastasis (LNM) (risk ratio (RR) 2.12, confidence interval (CI) 1.19–3.81, p = 0.011), patient American Society of Anesthesiologists (ASA) physical status classification system > 2 (RR 2.10, CI 1.03–4.26, p = 0.043), and depth of tumour penetration (pT) > 2 (RR 2.58, CI 1.03–6.30, p = 0.043). The presence of locoregional LNM (RR 2.95, CI 1.51–5.90, p = 0.002) and caudate lobe resection (RR 2.19, CI 1.01–5.14, p = 0.048) were found as independent predictors of DFS.ConclusionsCurative surgery for pCCA carries high risks with poor long-term survival. Locoregional LNM was the only predictor for both OS and DFS.

【 授权许可】

CC BY