High preoperative Glasgow prognostic score increases a risk of hospital mortality in elderly patients with perihilar cholangiocarcinoma

IF 2.8 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2025-02-13 DOI:10.1002/jhbp.12111

Takashi Kokumai, Shuichi Aoki, Kei Nakagawa, Masahiro Iseki, Hideaki Sato, Takayuki Miura, Shimpei Maeda, Masaharu Ishida, Masamichi Mizuma, Michiaki Unno

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Abstract

Background

Hemihepatectomy with extrahepatic bile duct resection is considered the only curative treatment for perihilar cholangiocarcinoma. The aim of the study was to clarify the survival benefits in this invasive surgical procedure for elderly patients.

Methods

A total of 290 patients who underwent surgical resection for perihilar cholangiocarcinoma in our department from 2000 to 2020 were categorized into the E group (62 patients aged ≥75 years) and NE group (228 patients aged <74 years).

Results

The E group exhibited decreased pathological lymph node metastasis (p = .001) and had a shorter operative time (p = .021) and fewer cases of combined vascular resection (p = .002). We found no significant differences in postoperative mortality; however, disease-specific survival was significantly better in the E group (3-year survival: 75.6 vs. 60.3%, p = .031). After propensity score matching, overall survival and disease-specific survival did not differ between the two groups; nevertheless, the hospital mortality rate was significantly higher in the E group (11.5 vs. 1.6%, p = .020). In the E group, a high preoperative Glasgow prognostic score was the only factor associated with hospital mortality (odds ratio, 7.35; p = .026) and indicated worse prognosis.

Conclusions

A high preoperative Glasgow prognostic score was associated with hospital mortality and poor prognosis in elderly patients with perihilar cholangiocarcinoma.

Abstract Image

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术前高格拉斯哥预后评分增加老年肝门周围胆管癌患者住院死亡的风险。

背景：半肝切除加肝外胆管切除被认为是治疗肝门周围胆管癌的唯一有效方法。该研究的目的是阐明这种侵入性手术对老年患者的生存益处。方法：2000 ~ 2020年我科290例行肝门周围胆管癌手术切除的患者分为E组（年龄≥75岁62例）和NE组（年龄228例）。结果：E组病理淋巴结转移减少（p = 0.001），手术时间缩短（p = 0.021），联合血管切除较少（p = 0.002）。我们发现术后死亡率没有显著差异；然而，E组的疾病特异性生存率明显更好（3年生存率：75.6比60.3%,p = 0.031）。倾向评分匹配后，两组的总生存率和疾病特异性生存率没有差异；然而，E组的住院死亡率明显高于对照组（11.5% vs. 1.6%, p = 0.020）。在E组，术前高格拉斯哥预后评分是唯一与住院死亡率相关的因素(优势比，7.35；P = 0.026)，预后较差。结论：术前高格拉斯哥预后评分与老年肝门周围胆管癌患者的住院死亡率和不良预后相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY

自引率

10.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.