The Impact of a Preoperative Staging System on Accurate Prediction of Prognosis in Intrahepatic Cholangiocarcinoma

Cancers

Fumitoshi Hirokawa¹  Koji Komeda¹  Mitsugu Sekimoto²  Kosuke Matsui²  Hisashi Kosaka²  Masaki Kaibori²  Daisuke Hokuto³  Hiroya Iida⁴  Masaki Ueno⁵ 

[1] Department of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan;Department of Surgery, Kansai Medical University, Hirakata 573-1010, Japan;Department of Surgery, Nara Medical University, Kashihara 634-8521, Japan;Department of Surgery, Shiga University of Medical Science, Otsu 520-2192, Japan;Second Department of Surgery, Wakayama Medical University, Wakayama 641-8509, Japan;

关键词: intrahepatic cholangiocarcinoma;    cancer staging;    tumor staging;   

DOI  :  10.3390/cancers14051107

来源: DOAJ

【 摘 要 】

Background: Non-invasive biomarkers detected preoperatively are still inadequate for treatment decision making for patients with intrahepatic cholangiocarcinoma (ICC). In this study, we analyzed preoperative findings to establish a novel preoperative staging system (PRE-Stage) for patients with ICC. Methods: The clinical data of 227 consecutive patients with histologically confirmed ICC following hepatectomy at five university hospitals were analyzed. Results: Cox proportional hazards regression analysis of survival revealed that a CRP–albumin–lymphocyte index < 3, central tumor location, and CA19-9 level > 40 U/mL were prognostic factors among the preoperatively obtained clinical findings (hazard ratios (HRs) of all three factors for disease-specific survival (DSS) and disease-free survival (DFS: 2.4–3.3 and 1.7–2.9; all p < 0.05). The PRE-Stage was developed using these three prognostic factors, and it was able to significantly predict DSS and DFS when the patients were stratified into four stages (p < 0.05). In addition, the PRE-Stage resulted in similar HRs as those of the Liver Cancer Study Group of Japan (LCSGJ) stage (HRs for DSS: PRE-Stage, 1.985; LCSGJ stage, 1.923; HRs for DFS: LCSGJ stage, 1.909, and PRE-Stage, 1.623, all p < 0.05). Conclusion: The PRE-Stage demonstrated similar accuracy in predicting the prognosis of ICC as that of the LCSGJ stage, which is based on postoperative findings. The PRE-Stage may contribute to appropriate treatment decision making.

【 授权许可】

Unknown