Prognostic Factors Associated with Preoperative Clinicophysiological Outcomes of Distal Cholangiocarcinoma.
OBJECTIVE
Although biliary tract cancer is generally associated with a high mortality rate, patients with distal cholangiocarcinoma have better prognoses, compared to those with periampullary cancer. This study aimed to determine the preoperative clinicophysiological factors predictive of survival and recurrence in patients with distal cholangiocarcinoma.


METHODS
Forty-five patients (34 men) with distal cholangiocarcinoma who underwent pancreaticoduodenectomy between 2005 and 2013 were examined retrospectively at our center and associated hospitals. Clinicophysiological parameters included predictors of overall survival (OS). Kaplan-Meier survival curves were generated and compared using log-rank tests, and Cox proportional hazard multivariate analyses were performed.


RESULTS
The mean patient age was 68.8 years (range 54-81 years). Patients had a median OS duration of 43 months, and 1-, 3-, and 5-year OS rates of 91.1, 61.1, and 40.4%, respectively. Univariate analyses indicated that the body mass index, C-reactive protein (CRP) level, and carcinoembryonic antigen level were independent prognostic factors for OS; however, only the CRP level remained an independent prognostic factor in a multivariate analysis.


CONCLUSIONS
A CRP level <0.3 mg/dL was predictive of a better outcome among patients with distal cholangiocarcinoma.
Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University, Ibaraki, Japan.
Shuji
S
Suzuki
Hideki
H
Kajiyama
Mitsugi
M
Shimoda
Jiro
J
Shimazaki
Nobusada
N
Koike
Nobuhiko
N
Harada
D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D002097:C-Reactive Protein / Q000378:metabolism*; D018281:Cholangiocarcinoma / Q000097:blood / Q000556:secondary / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D016577:Pancreaticoduodenectomy; D057234:Preoperative Period; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D047368:Tumor Burden
D002097:C-Reactive Protein
C-reactive protein; Clinicophysiological factor; Distal cholangiocarcinoma; Overall survival; Pancreaticoduodenectomy