title: Resected biliary tract cancers: a novel clinical-pathological score correlates with global outcome.
abstract: BACKGROUND
  Biliary tract cancer presents a poor prognosis.
  
  
  OBJECTIVE
  The objective of this study is to find clinical-laboratory parameters like prognostic factors to select patients who can benefit from surgery and post-operative treatments.
  
  
  METHODS
  Between 2005 and 2010, 41 patients underwent radical surgery at our Institution. A novel score was retrospectively calculated assigning a grade to the clinical-laboratory findings at diagnosis. 0 and 1 point were respectively assigned to the normal or abnormal parameter. Two groups were identified: SCORE 0 and SCORE 1.
  
  
  RESULTS
  Patients with cholangiocarcinoma or Klatskin tumours or asymptomatic at diagnosis presented a significantly better overall survival (OS) than patients with different primary sites or who presented pain, jaundice or cholangitis. At univariate analysis, high levels of aspartate aminotransferase, alanine aminotransferase and CA19-9 before surgery, hyperbilirubinemia before and after surgery had a negative correlation with OS. A worse OS was observed in patients with a higher score (median OS in the "score 0" group=30.79 months vs. median OS in the "score 1"=17.98 months).
  
  
  CONCLUSIONS
  Our results suggest that pre and post-surgery clinical-laboratory parameters and the novel score, could be useful, especially for intrahepatic tumours, in predicting the outcome in patients undergoing surgery and in selecting patients to receive adjuvant therapy.
authors.affiliation: Medical Oncology, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, GM Lancisi, G Salesi, Ancona, Italy. r.berardi@univpm.it
authors.forename: Rossana
authors.initials: R
authors.lastname: Berardi
authors.forename: Federico
authors.initials: F
authors.lastname: Mocchegiani
authors.forename: Chiara
authors.initials: C
authors.lastname: Pierantoni
authors.forename: Alen
authors.initials: A
authors.lastname: Federici
authors.forename: Daniele
authors.initials: D
authors.lastname: Nicolini
authors.forename: Francesca
authors.initials: F
authors.lastname: Morgese
authors.forename: Azzurra
authors.initials: A
authors.lastname: Onofri
authors.forename: Andrea
authors.initials: A
authors.lastname: Risaliti
authors.forename: Marco
authors.initials: M
authors.lastname: Vivarelli
authors.forename: Stefano
authors.initials: S
authors.lastname: Cascinu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001661:Biliary Tract Neoplasms / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005706:Gallbladder Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D006932:Hyperbilirubinemia; D018285:Klatskin Tumor / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate; C578959:carbohydrate antigen 199, human; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase