Survival analysis and prognostic nomogram for patients undergoing resection of extrahepatic cholangiocarcinoma

Abstract

Tumor location of extrahepatic CCA does not independently predict cancer-specific survival after resection. We developed a nomogram, based on a prognostic model with lymph node status, microscopically residual tumor status of resection margins, and tumor differentiation grade, that predicted survival better than TNM staging.

Pancreaticoduodenectomy for distal cholangiocarcinoma: surgical results, prognostic factors, and long-term follow-up

“…Distal cholangiocarcinoma still remains a disease with a poor prognosis due to local recurrence and distant metastatic spread. Tumor differentiation and nodal status have been confirmed as important prognostic factors in univariate analysis as already investigated in previous studies [14,19,24,30,31]. Metastatic spread to locoregional lymph nodes is a major negative prognostic factor, but the correct staging requires harvesting a number of lymph nodes that cannot be obtained with a simple bile duct resection alone.…”

Long-Term Outcome of Distal Cholangiocarcinoma after Pancreaticoduodenectomy Followed by Adjuvant Chemoradiotherapy: A 15-Year Experience in a Single Institution

“…A positive resection margin has been considered as an adverse prognostic factor in some studies [6,7,11,13]; however, its prognostic impact has not been fully determined because of inconsistent results among studies and diverse definitions. Incidences of a positive resection margin in EHBD cancer after curative resection can vary from 10% to as high as 70%, which can be explained by differences between surgeons regarding the principle of the operation or the definition of a positive resection margin, such as whether to include carcinoma in situ [15-19].…”

Clinical Characteristics and Treatment Outcomes of Patients with Unresectable Cholangiocarcinoma in Thailand: Are there Differences Dependent on Stent Type?

“…Although advances in radical surgical treatment in resectable cases of this malignancy improved the clinical outcomes, the 5-year survival rate was only 25-43%. Chemotherapy is not effective for palliative treatment in advanced cases; therefore, the median survival of patients with unresectable CCA was only 3-13 months (Nagino et al, 2008;Akamatsu et al, 2011;Van der Gaag et al, 2012). Regarding the data of poor treatment outcomes for unresectable CCA despite adjuvant chemotherapy or radiation treatment (Shin et al, 2010;Aslanian and Jamidar, 2011;Sangchan et al, 2012;Ruys et al, 2012), many patients preferred only palliative treatment, particularly biliary drainage.…”