Clinical Value of Inflammation-Based Prognostic Scores to Predict the Resectability of Hyperbilirubinemia Patients with Potentially Resectable Hilar Cholangiocarcinoma

Hu, Hai‐Jie; Jin, Yu; Zhou, Rongxing; Ma, Wen‐Jie; Yang, Qin; Wang, Junke; Li, Fu Yu; Cheng, Nan‐Sheng

doi:10.1007/s11605-018-3892-9

Cited by 20 publications

(18 citation statements)

References 36 publications

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“…The NLR has been associated with worse prognosis in various cancers [ 10 – 12 ]. However, because of the inconsistent results, whether PLR is associated with the prognosis in CCA remains controversial [ 13 – 15 ]. We therefore conducted a meta-analysis to assess the prognostic role of PLR and analyze the relationships between PLR and clinicopathological parameters in patients with CCA.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Significance of Platelet-to-Lymphocyte Ratio in Cholangiocarcinoma: A Meta-Analysis

et al. 2018

BioMed Research International

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Introduction Pretreatment platelet-to-lymphocyte ratio (PLR) has been considered a prognostic factor in various cancers. However, the application of PLR in the assessment of patients with cholangiocarcinoma remains controversial. This study aimed to evaluate the prognostic value of pretreatment PLR in cholangiocarcinoma. Methods A systematic search was performed in MEDLINE, EMBASE, and Cochrane Library to identify studies assessing the prognostic significance of the pretreatment PLR in cholangiocarcinoma. Three databases were searched from inception to August 5, 2018. The primary outcome was overall survival (OS), and the secondary outcomes were recurrence-free survival (RFS) and progression-free survival (PFS). Pooled hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models. Results A total of 9 studies including 2395 patients were finally enrolled in the meta-analysis based on the inclusion and exclusion criteria. All of the included studies were retrospective observational cohorts. Elevated PLR predicted poor OS (HR: 1.38, 95% CI: 1.19-1.62, P < 0.001) and RFS or PFS (HR = 1.55; 95% CI = 1.27-1.88; P < 0.001). Moreover, elevated PLR was highly associated with male sex (male versus female OR = 0.59, 95% CI: 0.44-0.80, P < 0.001) and R1 resection margin (OR = 2.09, 95% CI: 1.24-3.54, P = 0.006). Conclusion The present meta-analysis demonstrated that pretreatment PLR might serve as a useful prognostic biomarker in cholangiocarcinoma.

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Section: Introductionmentioning

confidence: 99%

Prognostic Significance of Platelet-to-Lymphocyte Ratio in Cholangiocarcinoma: A Meta-Analysis

et al. 2018

BioMed Research International

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“…Several studies associated en bloc caudate (22,44,46,47,52,58,66,68). Our previous studies did not identify any correlation between en bloc caudate lobectomy and overall survival in patients resected for PHC (21).…”

Section: Caudate Lobectomy and Long-term Survival In Phcmentioning

confidence: 70%

“…Increasing rates of caudate lobectomy were reported in large series of curative intent surgery for PHC published in the last 5 years: 35.3% -100%. The adoption rate of en bloc caudate lobectomy appears to remain higher in East Asian surgical centres, compared to Western centres (7,21,(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55).…”

Section: Caudate Lobectomy -How Frequent Is It Used In Surgery For Phc?mentioning

confidence: 95%

“…Thus, there are no randomized studies. Furthermore, most studies have a retrospective design (12,15,(21)(22)(23)44,46,51,52,55,(57)(58)(59)(60)(61)(62)(65)(66)(67)(68) and only four studies are comparative, un-matched studies (44,57,59,60) (Table 1). There is also evidence coming from an expert opinion (42).…”

Section: The Role Of Caudate Lobectomy In Phc -What Is the Level Of Ementioning

confidence: 99%

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Caudate Lobectomy for Perihilar Cholangiocarcinoma - Current Evidence

Dumitraşcu¹,

Ionescu²

2019

chr

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Chirurgia reprezintă singura şansă de supravieţuire pe termen lung pentru pacienţii diagnosticaţi cu colangiocarcinom perihilar. Rezecţia cu viză curativă a cunoscut de-a lungul anilor îmbunătăţiri semnificative, pornind de la rezecţia doar a căii biliare principale şi ajungând la proceduri chirurgicale complexe ce includ limfodisecţia loco-regională, rezecţii hepatice majore şi, uneori, rezecţii vasculare asociate. Acest tip modern de abord chirurgical a dus la îmbunătăţirea substanţială a supravieţuirii acestor pacienţi, în pofida unei rate mari de complicaţii postoperatorii. În Europa şi America, rezulatele iniţiale ale acestui tip complex de abord chirurgical incluzând rezecţii hepatice majore au fost dezamăgitoare deoarece s-au asociat cu rate ale mortalităţii postoperatorii inacceptabil de mari. Astăzi, mortalitatea după rezecţia colangiocarcinoamelor perihilare a scăzut semificativ, dar totuşi rata mortalităţii în centrele din Europa şi America rămâne mai mare decât rata raportată în centrele din Estul Asiei. Aceste diferenţe de rezultate între centrele din Europa-America şi Estul Asiei nu sunt explicate doar prin diferenţele de abord terapeutic dar şi de caracteristicile diferite ale pacienţilor din cele două părţi ale lumii. Rezecţia în bloc a lobului caudat ca parte a rezecţiilor radicale pentru colangiocarcinoame perihilare a fost introdusă în practica clinică de mai bine de trei decenii. Susţinerea rezecţiei de lob caudat se bazează pe modalitatea de răspandire locală a acestui tip de tumori precum şi pe faptul că invazia de lob caudat este un fapt frecvent întâlnit în acest tip de tumori. Rezecţia de lob

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“…At the moment, the use of preoperative biliary drainage and portal vein embolization in curative-intent surgery for PHC is higher in East Asian surgical centres (27)(28)(29)(30)(31)(32)(33)(82)(83)(84)(85), compared to the Western centres (34,35,40,43,52,79,(86)(87)(88)(89)(90).…”

Section: Discussion Discussionmentioning

confidence: 99%

Operative Management and Outcomes of 150 Patients with Curative-intent Surgery for Perihilar Cholangiocarcinomas: A Single Institute East European Perspective

Dumitraşcu¹,

Brasoveanu²,

Stroescu³

et al. 2018

SGO

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Introduction:The knowledge of current approach and outcomes of curative-intent surgery for perihilar cholangiocarcinoma (PHC) has been highlighted in studies of the literature including mainly East Asian and Western patients. Thus, papers presenting the curative-intent surgery in East Europe are scarce. The study aims to present the operative management and outcomes of curative-intent surgery for PHC in an East European institutional experience. Patients and methods: The data of all patients with curative-intent surgery for PHC between 1996 and 2017 were retrospectively reviewed from a prospective maintained electronic database at our Department of Surgery. The assessment was made for the operative management and early and late outcomes. Results: Liver resections were performed in 80.7% of patients, with caudate lobectomies in 64.7% of cases. Vascular resections were performed in 19.4% of patients. Preoperative biliary drainage was performed in 26% of patients. Negative resection margins were obtained in 76.7% of patients. Overall and severe morbidity rates were 57.3% and 24%, respectively. Postoperative bile leak, liver failure and hemorrhage rates were 31.3%, 24.7% and 10%, respectively. The 90-day mortality rate was 6%. The median overall and disease-free survival times were 26 months and 21 months, respectively. Conclusion: The standard approach for curative-intent surgery for PHC implies bile duct resection associated with major hepatectomies, including caudate lobectomy. Expertise in referral surgical centers of East Europe is associated with morbidity, mortality and overall survival rates comparable with those reported in Western centres, despite low rate of preoperative biliary drainage and no use of portal vein embolization. Improvements of preoperative optimization with portal vein embolization and biliary drainage may potentially lead to better early and long-term outcomes.

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Clinical Value of Inflammation-Based Prognostic Scores to Predict the Resectability of Hyperbilirubinemia Patients with Potentially Resectable Hilar Cholangiocarcinoma

Abstract: Patients with higher GPS, CA 125, and PLR levels, and a larger tumor size, tend to have unresectable tumors even if they were judged as potentially resectable using preoperative radiological examinations.

Cited by 20 publications

References 36 publications

Prognostic Significance of Platelet-to-Lymphocyte Ratio in Cholangiocarcinoma: A Meta-Analysis

Prognostic Significance of Platelet-to-Lymphocyte Ratio in Cholangiocarcinoma: A Meta-Analysis

Caudate Lobectomy for Perihilar Cholangiocarcinoma - Current Evidence

Operative Management and Outcomes of 150 Patients with Curative-intent Surgery for Perihilar Cholangiocarcinomas: A Single Institute East European Perspective

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