| Resection for Hilar Cholangiocarcinoma: Analysis of Prognostic Factors and the Impact of Systemic Inflammation on Long-term Outcome. | |
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MedLine Citation:
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PMID: 23319395 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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INTRODUCTION: Resection for hilar cholangiocarcinoma is the single hope for long-term survival. METHODS: Ninety patients underwent curative intent surgery for hilar cholangiocarcinoma between 1996 and 2012. The potential prognostic factors were assessed by univariate (Kaplan-Meier curves and log-rank test) and multivariate analyses (Cox proportional hazards model). RESULTS: The median overall and disease-free survivals were 26 and 17 months, respectively. The multivariate analysis identified R0 resection (HR = 0.03, 95 % CI 0-0.19, p < 0.001), caudate lobe invasion (HR = 6.33, 95 % CI 1.31-30.46, p = 0.021), adjuvant gemcitabine-based chemotherapy (HR = 0.38, 95 % CI 0.15-0.94, p = 0.037), and the neutrophil-to-lymphocyte ratio (HR = 0.78, 95 % CI 0.62-0.98, p = 0.036) as independent prognostic factors for disease-free survival. The independent prognostic factors for overall survival were R0 resection (HR = 0.03, 95 % CI 0-0.22, p < 0.001), caudate lobe invasion (HR = 11.75, 95 % CI 1.65-83.33, p = 0.014), and adjuvant gemcitabine-based chemotherapy (HR = 0.19, 95 % CI 0.06-0.56, p = 0.003). CONCLUSIONS: The negative resection margin represents the most important prognostic factor. Adjuvant gemcitabine-based chemotherapy appears to benefit survival. The neutrophil-to-lymphocyte ratio may potentially be used to stratify patients for future clinical trials. |
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Authors:
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Traian Dumitrascu; Dragos Chirita; Mihnea Ionescu; Irinel Popescu |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-1-15 |
Journal Detail:
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Title: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract Volume: - ISSN: 1873-4626 ISO Abbreviation: J. Gastrointest. Surg. Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-1-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9706084 Medline TA: J Gastrointest Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Center of General Surgery and Liver Transplant, Fundeni Clinical Institute, Fundeni Street no 258, 022328, Bucharest, Romania, traian.dumitrascu@srchirurgie.ro. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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