Resection for Hilar Cholangiocarcinoma: Analysis of Prognostic Factors and the Impact of Systemic Inflammation on Long-term Outcome View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2013-05

AUTHORS

Traian Dumitrascu, Dragos Chirita, Mihnea Ionescu, Irinel Popescu

ABSTRACT

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. More... »

PAGES

913-924

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  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s11605-013-2144-2

    DOI

    http://dx.doi.org/10.1007/s11605-013-2144-2

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1040324108

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/23319395


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