title: Appraisal of inflammation-based prognostic scores in patients with unresectable perihilar cholangiocarcinoma.
abstract: BACKGROUND
  Inflammation-based prognostic scores are useful prognostic indicators for several types of cancer. The aim of this study was to evaluate whether the scores predict survival impact in unresectable perihilar cholangiocarcinoma.
  
  
  METHODS
  The modified Glasgow Prognostic Score (mGPS), Neutrophil Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio, and Prognostic Nutritional Index, were retrospectively assessed in 219 patients with unresectable perihilar cholangiocarcinoma.
  
  
  RESULTS
  Of the four scores evaluated, mGPS and NLR demonstrated prognostic value, whereas the remaining two systems did not. The median survival time (MST) of patients with a mGPS of 0 and NLR of 0 or 1 were significantly better than that of patients with a mGPS of 1 or 2 and NLR of 2 (12.3 vs. 4.8 months, P < 0.001, and 10.5 vs. 4.4 months, P = 0.001). Multivariate analysis revealed that both mGPS and NLR were independent prognostic factors. The combination of mGPS and NLR stratified survival well: the MST was 12.8 months in patients with a mGPS of 0 and NLR of 1 or 2, while only 3.0 months in patients with a mGPS of 1 or 2 and NLR of 2.
  
  
  CONCLUSIONS
  Both mGPS and NLR are independent prognostic factors and pivotal in refining patient stratification in unresectable perihilar cholangiocarcinoma.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Okuno
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Ebata
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Yokoyama
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Igami
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan.
authors.forename: Gen
authors.initials: G
authors.lastname: Sugawara
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Mizuno
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan.
authors.forename: Junpei
authors.initials: J
authors.lastname: Yamaguchi
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan. nagino@med.nagoya-u.ac.jp.
authors.forename: Masato
authors.initials: M
authors.lastname: Nagino
mesh_terms: D000367:Age Factors; D000368:Aged; D001650:Bile Duct Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D002423:Cause of Death; D015331:Cohort Studies; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000473:pathology; D007564:Japan; D053208:Kaplan-Meier Estimate; D018285:Klatskin Tumor / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D018655:Lymphocyte Count; D016246:Lymphocytes, Tumor-Infiltrating / Q000166:cytology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D009504:Neutrophils / Q000166:cytology; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D018709:Statistics, Nonparametric; D016019:Survival Analysis
keywords: Glasgow prognostic score; Neutrophil lymphocyte ratio; Perihilar cholangiocarcinoma; Prognosis; Survival analysis