title: Long-term outcome after surgical resection for cholangiocarcinoma and prognostic index value.
abstract: OBJECTIVE
  To investigate the prognostic factors of patients with cholangiocarcinoma and establish a prognostic model to evaluate the prognosis.
  
  
  METHODS
  169 cases of cholangiocarcinoma were analyzed retrospectively. Clinicopathological factors were evaluated using univariate and multivariate analysis. Prognostic index (PI) was calculated based on the results of multivariate analysis. Patients with different PI were divided into 3 groups in order to compare the survival rate of each group and draw the survival curves. Individual expected survival rate was calculated based on the prognostic Cox model and PI. The PI equation was built that included all significant variables and coefficients as follow formula: PI = (β1 × lymph node metastasis) + (β2 × CEA level) - (β3 × surgical margin).
  
  
  RESULTS
  Univariate analysis showed that CEA, lymph node metastasis, surgical margin, AJCC staging, tumor differentiation and adjuvant chemotherapy were prognostic impacts. The difference was statistically significant (p < 0.05). Cox multivariate analysis showed that CEA, lymph node metastasis and surgical margin are three separate prognostic factors. According to different PI, patients were divided into high-risk group, middle-risk group and low-risk group and three groups were statistically significant difference in survival rate (P < 0.05).
  
  
  CONCLUSIONS
  Racical resection is the key to improve the long-term survival rate of cholangiocarcinoma. By using prognostic Cox model and the PI, the prognosis of patients could be estimated and individualized clinical treatment could be conducted.
authors.affiliation: The Department of Anesthesiology, Liaoning Cancer Hospital and Institute, Shenyang, China. Electronic address: gre031025@gmail.com.
authors.forename: Yue
authors.initials: Y
authors.lastname: Wang
authors.affiliation: The Department of Internal Medicine, Liaoning Cancer Hospital and Institute, Shenyang, China.
authors.forename: Boshi
authors.initials: B
authors.lastname: Duan
authors.affiliation: The Department of Anesthesiology, Liaoning Cancer Hospital and Institute, Shenyang, China.
authors.forename: Lihui
authors.initials: L
authors.lastname: Yan
authors.affiliation: The Department of General Surgery, Shen Zhou Hospital, Shen Yang Medical College, Shenyang, China.
authors.forename: Chunjian
authors.initials: C
authors.lastname: Shen
authors.affiliation: Shen Yang Emergency Center, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Wu
authors.affiliation: The Department of General Surgery, The First Hospital of China Medical University, Shenyang, China.
authors.forename: Ji
authors.initials: J
authors.lastname: Luo
authors.affiliation: The Department of General Surgery, Huaxi Hospital, Si Chuan University, Chengdu, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Shen
authors.affiliation: The Department of Gastric Surgery, Liaoning Cancer Hospital and Institute, Shenyang, China.
authors.forename: Guohua
authors.initials: G
authors.lastname: Zhao
mesh_terms: D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D002681:China / Q000453:epidemiology; D018281:Cholangiocarcinoma / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cholangiocarcinoma; Prognosis; Survival