Tags

Type your tag names separated by a space and hit enter

Assessment of clinical outcomes of advanced hilar cholangiocarcinoma.
Hepatobiliary Pancreat Dis Int. 2018 Apr; 17(2):155-162.HP

Abstract

BACKGROUND

Low resectability and poor survival outcome are common for hilar cholangiocarcinoma (HCCA), especially in advanced stages. The present study was to assess the clinical outcome of advanced HCCA, focusing on therapeutic modalities, survival analysis and prognostic assessment.

METHODS

Clinical data of 176 advanced HCCA patients who had been treated in our hospital between January 2013 and December 2015 were analyzed retrospectively. Prognostic effects of clinicopathological factors were explored by univariate and multivariate analysis. Survival predictors were evaluated by the receiver operating characteristic (ROC) curve.

RESULTS

The 3-year overall survival rate was 13% for patients with advanced HCCA. Preoperative total bilirubin (P = 0.009), hepatic artery invasion (P = 0.014) and treatment modalities (P = 0.020) were independent prognostic factors on overall survival. A model combining these independent prognostic factors (area under ROC curve: 0.748; 95% CI: 0.678-0.811; sensitivity: 82.3%, specificity: 53.5%) was highly predictive of tumor death. After R0 resection, the 3-year overall survival was up to 38%. Preoperative total bilirubin was still an independent negative factor, but not for hepatic artery invasion.

CONCLUSIONS

Surgery is still the best treatment for advanced HCCA. Preoperative biliary drainage should be performed in highly-jaundiced patients to improve survival. Prediction of survival is improved significantly by a model that incorporates preoperative total bilirubin, hepatic artery invasion and treatment modalities.

Authors+Show Affiliations

Division of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.Division of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.Division of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.Division of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.Division of Hepatobiliary Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China. Electronic address: shusenzheng@zju.edu.cn.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29636302

Citation

Chen, Kang-Jie, et al. "Assessment of Clinical Outcomes of Advanced Hilar Cholangiocarcinoma." Hepatobiliary & Pancreatic Diseases International : HBPD INT, vol. 17, no. 2, 2018, pp. 155-162.
Chen KJ, Yang FC, Qin YS, et al. Assessment of clinical outcomes of advanced hilar cholangiocarcinoma. Hepatobiliary Pancreat Dis Int. 2018;17(2):155-162.
Chen, K. J., Yang, F. C., Qin, Y. S., Jin, J., & Zheng, S. S. (2018). Assessment of clinical outcomes of advanced hilar cholangiocarcinoma. Hepatobiliary & Pancreatic Diseases International : HBPD INT, 17(2), 155-162. https://doi.org/10.1016/j.hbpd.2018.03.003
Chen KJ, et al. Assessment of Clinical Outcomes of Advanced Hilar Cholangiocarcinoma. Hepatobiliary Pancreat Dis Int. 2018;17(2):155-162. PubMed PMID: 29636302.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Assessment of clinical outcomes of advanced hilar cholangiocarcinoma. AU - Chen,Kang-Jie, AU - Yang,Fu-Chun, AU - Qin,Yun-Sheng, AU - Jin,Jing, AU - Zheng,Shu-Sen, Y1 - 2018/03/06/ PY - 2017/07/04/received PY - 2018/12/27/accepted PY - 2018/4/11/pubmed PY - 2018/9/27/medline PY - 2018/4/12/entrez KW - Hepatic artery resection KW - Hilar cholangiocarcinoma KW - Preoperative biliary drainage KW - Prognostic factors SP - 155 EP - 162 JF - Hepatobiliary & pancreatic diseases international : HBPD INT JO - Hepatobiliary Pancreat Dis Int VL - 17 IS - 2 N2 - BACKGROUND: Low resectability and poor survival outcome are common for hilar cholangiocarcinoma (HCCA), especially in advanced stages. The present study was to assess the clinical outcome of advanced HCCA, focusing on therapeutic modalities, survival analysis and prognostic assessment. METHODS: Clinical data of 176 advanced HCCA patients who had been treated in our hospital between January 2013 and December 2015 were analyzed retrospectively. Prognostic effects of clinicopathological factors were explored by univariate and multivariate analysis. Survival predictors were evaluated by the receiver operating characteristic (ROC) curve. RESULTS: The 3-year overall survival rate was 13% for patients with advanced HCCA. Preoperative total bilirubin (P = 0.009), hepatic artery invasion (P = 0.014) and treatment modalities (P = 0.020) were independent prognostic factors on overall survival. A model combining these independent prognostic factors (area under ROC curve: 0.748; 95% CI: 0.678-0.811; sensitivity: 82.3%, specificity: 53.5%) was highly predictive of tumor death. After R0 resection, the 3-year overall survival was up to 38%. Preoperative total bilirubin was still an independent negative factor, but not for hepatic artery invasion. CONCLUSIONS: Surgery is still the best treatment for advanced HCCA. Preoperative biliary drainage should be performed in highly-jaundiced patients to improve survival. Prediction of survival is improved significantly by a model that incorporates preoperative total bilirubin, hepatic artery invasion and treatment modalities. SN - 1499-3872 UR - https://www.unboundmedicine.com/medline/citation/29636302/Assessment_of_clinical_outcomes_of_advanced_hilar_cholangiocarcinoma_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1499-3872(18)30055-9 DB - PRIME DP - Unbound Medicine ER -