Multivariate statistical analysis of clinicopathologic factors influencing survival of patients with bile duct carcinoma

He, Ping; Shi, Jinsen; Chen, Wuke; Wang, Zuoren; Ren, Hong; Li, Hua

doi:10.3748/wjg.v8.i5.943

Cited by 41 publications

(37 citation statements)

References 18 publications

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“…Therefore, a gross surgical margin of more than 1 cm in the infiltrating type and more than 2 cm in the papillary and nodular types is recommended to achieve negative microscopic resection margins. One of the special characteristics of CC is the presence of perineural invasion that is seen in about 75% of cases [163,164] . Perineural invasion is a prognostic factor for poor survival [164,165] .…”

Section: Tumor Spreadmentioning

confidence: 99%

Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009

Aljiffry¹,

Walsh²,

Molinari³

2009

WJG

254

190

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Several advances in diagnosis, treatment and palliation of cholangiocarcinoma (CC) have occurred in the last decades. A multidisciplinary approach to this disease is therefore recommended. CC is a relatively rare tumor and the main risk factors are: chronic inflammation, genetic predisposition and congenital abnormalities of the biliary tree. While the incidence of intra-hepatic CC is increasing, the incidence of extra-hepatic CC is trending down. The only curative treatment for CC is surgical resection with negative margins. Liver transplantation has been proposed only for selected patients with hilar CC that cannot be resected who have no metastatic disease after a period of neoadjuvant chemo-radiation therapy. Magnetic resonance imaging/ magnetic resonance cholangiopancreatography, positron emission tomography scan, endoscopic ultrasound and computed tomography scans are the most frequently used modalities for diagnosis and tumor staging. Adjuvant therapy, palliative chemotherapy and radiotherapy have been relatively ineffective for inoperable CC. For most of these patients biliary stenting provides effective palliation. Photodynamic therapy is an emerging palliative treatment that seems to provide pain relief, improve biliary patency and increase survival. The clinical utility of other emerging therapies such as transarterial chemoembolization, hepatic arterial chemoinfusion and high intensity intraductal ultrasound needs further study.

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Section: Tumor Spreadmentioning

confidence: 99%

Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009

Aljiffry¹,

Walsh²,

Molinari³

2009

WJG

254

190

View full text Add to dashboard Cite

show abstract

“…[3][4][5][6][7][8][9] The pancreatic invasion of the EBD carcinomas has been known to be a bad prognostic sign. 10,11 However, we experienced that several patients with the EBD carcinoma with superficial pancreatic invasion had a more favorable survival outcome than we expected.…”

mentioning

confidence: 70%

“…3,6,7,[15][16][17][18] The patients with the EBD carcinomas are known to have a poor survival when pancreatic invasion is present. 10,11 In the present study, we classified the distal EBD carcinomas according to the degree of the pancreatic invasion and compared the survival rate of each class. Cases with equal to or less than 1 mm of the pancreatic invasion (class 2) showed better survival rate than cases with more than 1 mm of the pancreatic invasion (class 3) and this difference was statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…This result was the same as those of the previously reported. 10,22 Tumor size is one of the important prognostic factors in tumors arising from solid parenchymal organs, while depth of invasion is one of the important prognostic factors in tumors of hollow viscus, such as intestine and urinary bladder. 8 Our results demonstrated that the depth of invasion appear to be more important prognostic factor than tumor size when distal EBD carcinomas involved the pancreas.…”

Section: Discussionmentioning

confidence: 99%

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Superficial vs deep pancreatic parenchymal invasion in the extrahepatic bile duct carcinomas: a significant prognostic factor

et al. 2005

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Pancreatic invasion of the extrahepatic bile duct (EBD) carcinomas is known to have a poor outcome. We hypothesized that EBD carcinoma showing shallow invasion to the pancreas may have a better outcome than the usual deep pancreatic invasion. We divided 87 cases of the distal EBD carcinomas into superficial and deep pancreatic invasion groups according to degrees of the pancreatic invasion. The superficial pancreatic invasion group included cases with tumor abutting the pancreatic lobule or pancreatic parenchymal invasion equal to or less than 1 mm from the uppermost portion of the pancreatic lobule or tumors invading into the fibroadipose tissue between pancreatic lobules without parenchymal invasion. The deep invasion group consisted of tumors with more than 1 mm pancreatic parenchymal invasion. The cases with superficial pancreatic invasion showed significantly better survival rate than those with deep pancreatic invasion (Po0.001). Therefore, we recommend that a specific remark on the pathology report about the presence or absence of parenchymal invasion and the depth of invasion of the pancreas is required for managing patients and determining the prognosis. We also recommend that the current pT3 stage of distal EBD carcinomas be subdivided into superficial (pT3a) and deep pancreatic invasion (pT3b). Modern Pathology (2005) 18, 969-975.

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“…Infection is one of the most common complication in patients with obstructive jaundice, which could lead to death perioperation (He et al, 2002;Dambraukas et al, 2003). In previous report, the incidence of infection after stenting is 6.5% -22% ( Shin et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Analysis of Different Ways of Drainage for Obstructive Jaundice Caused by Hilar Cholangiocarcinoma

Xu¹,

Lv²,

Huang³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Objective: To evaluate the prognosis of different ways of drainage for patients with obstructive jaundice caused by hilar cholangiocarcinoma. Materials and Methods: During the period of January 2006-March 2012, percutaneous transhepatic catheter drainage (PTCD)/ percutaneous transhepatic biliary stenting (PTBS) were performed for 89 patients. According to percutaneous transhepatic cholangiography (PTC), external drainage was selected if the region of obstruction could not be passed by guide wire or a metallic stent was inserted if it could. External drainage was the first choice if infection was diagnosed before the procedure, and a metallic stent was inserted in one week after the infection was under control. Selection by new infections, the degree of bilirubin decrease, the change of ALT, the time of recurrence of obstruction, and the survival time of patients as the parameters was conducted to evaluate the methods of different interventional treatments regarding prognosis of patients with hilar obstruction caused by hilar cholangiocarcinoma. Results: PTCD was conducted in 6 patients and PTBS in 7 (p<0.05). Reduction of bilirubin levels and ALT levels was obvious after the procedures (p<0.05). The average survival time with PTCD was 161 days and with PTBS was 243 days (p<0.05). Conclusions: With both drainage procedures for obstructive jaundice caused by hilar cholangiocarcinoma improvement in liver function was obvious. PTBS was found to be better than PTCD for prolonging the patient survival.

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Multivariate statistical analysis of clinicopathologic factors influencing survival of patients with bile duct carcinoma

Abstract: Pancreatic invasion, perineural invasion and lymph node metastases are the most important prognostic factors for bile duct carcinoma after curative resection.

Cited by 41 publications

References 18 publications

Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009

Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009

Superficial vs deep pancreatic parenchymal invasion in the extrahepatic bile duct carcinomas: a significant prognostic factor

Analysis of Different Ways of Drainage for Obstructive Jaundice Caused by Hilar Cholangiocarcinoma

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