Prognostic factors of distal cholangiocarcinoma after curative surgery: a series of 84 cases.
OBJECTIVE
The aim of this study was to identify useful prognostic factors for patients with distal cholangiocarcinoma.


METHODS
The records of 84 patients with distal cholangiocarcinoma undergoing pancreatoduodenectomy were retrospectively reviewed. Potential clinicopathological prognostic factors that may affect survival were examined by univariate and multivariate analyses.


RESULTS
There were two patients died within 30 days of surgery. Overall survival rates were 69.51%, 42.68%, and 36.59% for 1, 3 and 5 years, respectively (median survival time, 32.74 months). Univariate analysis found that alanine aminotransferase/aspartate aminotransferase (AST/ALT) ratio less than and equal to 2, serum bilirubin less than and equal to 171 micromol/L, CA19-9 level less than 150 U/L, tumor size less than 2 cm, absent neural invasion, and absent lymph node involvement were associated with higher survival rate (p < 0.05). Furthermore, multivariate analysis found that AST/ALT ratio more than 2, present lymph node involvement and present neural invasion were the independent risk factors of poor survival (p < 0.01).


CONCLUSIONS
These results suggest that not only the well-known lymph node involvement, but also neural invasion and AST/ALT ratio more than 2 might be useful prognostic factors for long-term survival in distal cholangiocarcinoma.
Xinyu
X
Tan
Ke
K
Xiao
Wei
W
Liu
Shi
S
Chang
Tian
T
Zhang
Huihuan
H
Tang
D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001650:Bile Duct Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology / Q000601:surgery*; D014408:Biomarkers, Tumor / Q000097:blood; D018281:Cholangiocarcinoma / Q000097:blood / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000401:mortality; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase