Analysis of treatment methods and prognostic factors in 354 cases of hilar cholangiocarcinoma

Sun, Zhaowei; Feng, Yujie; Líu, Hao; Shen, Fangzhen; Xiao, Jinming; Kang, Xiaoliang; Zhao, Yongrong; Xiao, Huining; Zhao, Wei; Hu, Xiao; Li, Jinliang; Ma, Haoyue; Cao, Guanghua; Su, Na; Zhang, Bingyuan

doi:10.4103/jcrt.jcrt_637_19

Cited by 13 publications

(9 citation statements)

References 27 publications

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“…Some studies have shown that a higher preoperative CA19-9 level is an important factor in reducing the survival rate of HCCA patients. 27 The results of the univariate analysis showed that the survival rate of patients with a preoperative CA19-9 level ≥ 150 U/mL was lower than that of patients with a preoperative CA19-9 < 150 U/mL, which was consistent with the above conclusions. Relevant literature reports that the probability of lymph node metastasis in HCCA is as high as 30-50%, which is an important factor affecting the survival of patients.…”

supporting

confidence: 82%

Risk Factors for Negative Emotions in Patients Undergoing Radical Resection of Hilar Cholangiocarcinoma and Their Influence on Prognosis

Yin,

Xu,

Zhu

et al. 2023

IJGM

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Background: Hilar cholangiocarcinoma (HCCA) is a common malignant tumor of the biliary system. Factors such as limited physical function, intractability, and high mortality caused by the tumor lead to negative emotions, such as anxiety and depression in patients. In this study, we investigated the risk factors for negative emotions in patients undergoing radical resection of HCCA during the perioperative period and its effect on prognosis to provide strategies for alleviating the negative emotional disorders of patients and improving prognosis. Methods: From September 2016 to August 2021, we retrospectively examined 205 patients with HCCA who underwent radical resection in our hospital. The incidence of negative emotions and the clinical parameters of patients were compared using Chi-square tests and t-tests. The independent risk factors for unfavorable feelings in patients during the perioperative period were determined using binary logistic regression. The key variables influencing the postoperative survival status of HCCA patients were identified using the log-rank univariate analysis and Cox proportional risk regression analysis. Results:The results of the binary logistic regression analysis showed that perioperative negative emotions were independently influenced by family monthly income (OR = 0.069), medical insurance (OR = 0.089), family care (OR = 0.013), sleep quality (OR = 0.071), TNF-α (OR = 5.851), and bile leakage (OR = 29.412) (P < 0.05). The age of the patient (OR = 2.003), preoperative CA19-9 (OR = 2.038), lymph node metastases (OR = 2.327), and negative mood (OR = 3.054) were independent risk variables that affected the survival status of patients, as determined by the results of Cox regression analysis (P < 0.05). Conclusion:In this study, we found that anxiety and depression in patients undergoing radical operation of HCCA are related to family monthly income, medical insurance, sleep quality, family care, TNF-α, and bile leakage; also, negative emotions have adverse effects on prognosis.

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supporting

confidence: 82%

Risk Factors for Negative Emotions in Patients Undergoing Radical Resection of Hilar Cholangiocarcinoma and Their Influence on Prognosis

Yin,

Xu,

Zhu

et al. 2023

IJGM

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“…Albumin is produced by the liver and is the most abundant protein in plasma. Serum albumin is an important factor in assessing the nutritional status of patients and has been widely reported to be closely related to the prognosis of various cancers, including HCCA (39)(40)(41). The expression of lymphocytes is critical in tumor defense and can promote the death of cytotoxic cells.…”

Section: Discussionmentioning

confidence: 99%

Controlling Nutritional Status (CONUT) Score as a New Indicator of Prognosis in Patients With Hilar Cholangiocarcinoma Is Superior to NLR and PNI: A Single-Center Retrospective Study

Wang

Peng

et al. 2021

Front. Oncol.

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BackgroundCurrently, many nutritional indicators, including controlling nutritional status score (CONUT), can be used to assess a patient’s nutritional status and have been reported as reliable predictors of multiple malignancies. However, the value of CONUT score in predicting postoperative outcomes in patients with hilar cholangiocarcinoma has not been explored. In this study, its predictive value will be discussed and compared with the known predictors the neutrophil lymphocyte ratio (NLR) and prognostic nutritional index (PNI).MethodsPreoperative CONUT scores, PNI and NLR levels of 94 Hilar cholangiocarcinoma (HCCA) patients who underwent radical-intent resection of hepatobiliary surgery in our hospital from March 2010 to April 2019 were retrospectively collected and analyzed. They were grouped according to their optimal cutoff value and the prognostic effects of patients in each group were compared respectively.ResultsCONUThigh was more frequent in patients with Clavien–Dindo classification of ≥IIIa (P = 0.008) and Bile leakage presence (P = 0.011). Kaplan-Meier curves analyzing the relationship between CONUT, PNI, and NLR values and HCCA patient survival (including total survival (OS) and recurrence-free survival (RFS) showed significant differences between groups (P <0.001). Meanwhile, multi-factor analysis found that Degree of cure, PNI, NLR, and preoperative CONUT score were independent prognostic factors for OS and RFS. The predictive power of CONUT score was higher than that of NLR and PNI based on time-dependent receiver operating Characteristic (ROC) analysis and the net reclassification index (NRI) and integrated discriminatory index (IDI) values (P < 0.05).ConclusionCONUT score may be of some clinical reference value in evaluating postoperative prognosis of HCCA patients.

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“…The remaining four studies found no significant association between serum bilirubin and OS. A recent large study found that raised preoperative serum bilirubin was associated with poorer median OS of 12 months versus 15.3 months, with HR = 1.63 (95% CI 1.02-2.59, p = 0.040) upon multivariable analysis [51]. This study used a lower cutoff value than a majority of the identified studies and did not define time of serum bilirubin measurement in relation to any interventions, although most of their cohort did not undergo preoperative biliary drainage.…”

Section: Serum Bilirubinmentioning

confidence: 98%

“…Raised preoperative serum bilirubin was significantly associated with OS upon univariable analysis in four [20,21,46,51] out of eight studies and remained significant in three of these upon multivariable analysis [20,46,51] (Table 2). The remaining four studies found no significant association between serum bilirubin and OS.…”

Section: Serum Bilirubinmentioning

confidence: 99%

“…Differences in preoperative interventions, degree of data reporting, and exact study designs may account for the variability in results. Importantly, seven out of the eight studies did not report whether serum bilirubin was measured in the context of an obstructed biliary system or following adequate preoperative biliary drainage [16,20,21,32,42,51,58]. Two studies investigated RFS, and both found no association between serum bilirubin and RFS [21,58].…”

Section: Serum Bilirubinmentioning

confidence: 99%

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Systematic Review of Preoperative Prognostic Biomarkers in Perihilar Cholangiocarcinoma

Pawaskar,

Huang,

Pham

et al. 2024

Cancers

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Perihilar cholangiocarcinoma (pCCA) is an uncommon malignancy with generally poor prognosis. Surgery is the primary curative treatment; however, the perioperative mortality and morbidity rates are high, with a low 5-year survival rate. Use of preoperative prognostic biomarkers to predict survival outcomes after surgery for pCCA are not well-established currently. This systematic review aimed to identify and summarise preoperative biomarkers associated with survival in pCCA, thereby potentially improving treatment decision-making. The Embase, Medline, and Cochrane databases were searched, and a systematic review was performed using the PRISMA guidelines. English-language studies examining the association between serum and/or tissue-derived biomarkers in pCCA and overall and/or disease-free survival were included. Our systematic review identified 64 biomarkers across 48 relevant studies. Raised serum CA19-9, bilirubin, CEA, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and tumour MMP9, and low serum albumin were most associated with poorer survival; however, the cutoff values used widely varied. Several promising molecular markers with prognostic significance were also identified, including tumour HMGA2, MUC5AC/6, IDH1, PIWIL2, and DNA index. In conclusion, several biomarkers have been identified in serum and tumour specimens that prognosticate overall and disease-free survival after pCCA resection. These, however, require external validation in large cohort studies and/or in preoperatively obtained specimens, especially tissue biopsy, to recommend their use.

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Analysis of treatment methods and prognostic factors in 354 cases of hilar cholangiocarcinoma

Cited by 13 publications

References 27 publications

Risk Factors for Negative Emotions in Patients Undergoing Radical Resection of Hilar Cholangiocarcinoma and Their Influence on Prognosis

Risk Factors for Negative Emotions in Patients Undergoing Radical Resection of Hilar Cholangiocarcinoma and Their Influence on Prognosis

Controlling Nutritional Status (CONUT) Score as a New Indicator of Prognosis in Patients With Hilar Cholangiocarcinoma Is Superior to NLR and PNI: A Single-Center Retrospective Study

Systematic Review of Preoperative Prognostic Biomarkers in Perihilar Cholangiocarcinoma

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