Hyun Jeong Jeon, So Jeong Yoon, Ho Chang Chae, Hyeong Seok Kim, Sang Hyun Shin, In Woong Han, Jin Seok Heo, Hongbeom Kim
{"title":"Impact of preoperative prognostic factors on survival outcomes in intrahepatic cholangiocarcinoma: a retrospective cohort study.","authors":"Hyun Jeong Jeon, So Jeong Yoon, Ho Chang Chae, Hyeong Seok Kim, Sang Hyun Shin, In Woong Han, Jin Seok Heo, Hongbeom Kim","doi":"10.4174/astr.2025.108.6.345","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study assesses preoperative prognostic factors in intrahepatic cholangiocarcinoma (ICC) to improve risk assessment and inform clinical decisions, focusing on the role of lymph node dissection (LND).</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 234 patients who underwent surgery for ICC at a single institution between 2010 and 2019. Prognostic factors affecting overall survival (OS) were identified through univariate and multivariable logistic regression analyses. Patients were categorized into high-, intermediate-, and low-risk groups based on the number of adverse prognostic factors. Survival curves were compared between the groups that underwent LND and those that did not within each risk category.</p><p><strong>Results: </strong>Of the 234 patients, 138 (59.0%) underwent LND, and 96 (41.0%) did not (non-LND). Significant prognostic factors included preoperative elevation of CEA (>5 ng/mL), CA 19-9 (>37 U/mL), tumor multiplicity, tumor size >5 cm, and extrahepatic invasion. These factors were associated with adverse OS (hazard ratio ranging from 1.69 to 2.54). High-risk patients had significantly lower median OS compared to intermediate and low-risk groups in both LND and non-LND cohorts, but no significant difference in median OS between LND and non-LND groups within each risk category was observed.</p><p><strong>Conclusion: </strong>Preoperative prognostic factors such as CEA, CA 19-9, tumor size, and multiplicity are vital for assessing patient risk in ICC. These factors guide clinical decision-making and emphasize the need for targeted treatment strategies, including the consideration of LND, particularly in high-risk patients. The study underscores the importance of these prognostic indicators in enhancing treatment outcomes.</p>","PeriodicalId":8071,"journal":{"name":"Annals of Surgical Treatment and Research","volume":"108 6","pages":"345-351"},"PeriodicalIF":1.2000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149987/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Surgical Treatment and Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4174/astr.2025.108.6.345","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/2 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: This study assesses preoperative prognostic factors in intrahepatic cholangiocarcinoma (ICC) to improve risk assessment and inform clinical decisions, focusing on the role of lymph node dissection (LND).
Methods: We conducted a retrospective analysis of 234 patients who underwent surgery for ICC at a single institution between 2010 and 2019. Prognostic factors affecting overall survival (OS) were identified through univariate and multivariable logistic regression analyses. Patients were categorized into high-, intermediate-, and low-risk groups based on the number of adverse prognostic factors. Survival curves were compared between the groups that underwent LND and those that did not within each risk category.
Results: Of the 234 patients, 138 (59.0%) underwent LND, and 96 (41.0%) did not (non-LND). Significant prognostic factors included preoperative elevation of CEA (>5 ng/mL), CA 19-9 (>37 U/mL), tumor multiplicity, tumor size >5 cm, and extrahepatic invasion. These factors were associated with adverse OS (hazard ratio ranging from 1.69 to 2.54). High-risk patients had significantly lower median OS compared to intermediate and low-risk groups in both LND and non-LND cohorts, but no significant difference in median OS between LND and non-LND groups within each risk category was observed.
Conclusion: Preoperative prognostic factors such as CEA, CA 19-9, tumor size, and multiplicity are vital for assessing patient risk in ICC. These factors guide clinical decision-making and emphasize the need for targeted treatment strategies, including the consideration of LND, particularly in high-risk patients. The study underscores the importance of these prognostic indicators in enhancing treatment outcomes.
期刊介绍:
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