Impact of preoperative prognostic factors on survival outcomes in intrahepatic cholangiocarcinoma: a retrospective cohort study.

IF 1.2 4区 医学 Q3 SURGERY
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.

术前预后因素对肝内胆管癌患者生存结果的影响:一项回顾性队列研究。
目的:本研究评估肝内胆管癌(ICC)的术前预后因素,以改善风险评估并为临床决策提供依据,重点研究淋巴结清扫(LND)的作用。方法:我们对2010年至2019年在一家机构接受ICC手术的234例患者进行了回顾性分析。通过单变量和多变量logistic回归分析确定影响总生存期(OS)的预后因素。根据不良预后因素的数量,将患者分为高、中、低危组。在每个风险类别中,比较LND组和未接受LND组的生存曲线。结果:234例患者中,138例(59.0%)行LND, 96例(41.0%)未行(非LND)。术前CEA升高(bbb5 ng/mL)、ca19 -9升高(>37 U/mL)、肿瘤多样性、肿瘤大小bbb5 cm、肝外浸润等均为预后的重要影响因素。这些因素与不良OS相关(风险比1.69 ~ 2.54)。在LND和非LND队列中,高危患者的中位OS均明显低于中危组和低危组,但在各风险类别中,LND组和非LND组的中位OS无显著差异。结论:术前预后因素如CEA、CA 19-9、肿瘤大小和多样性是评估ICC患者风险的重要因素。这些因素指导临床决策,并强调需要有针对性的治疗策略,包括考虑LND,特别是在高危患者中。该研究强调了这些预后指标在提高治疗效果方面的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
2.30
自引率
7.10%
发文量
75
期刊介绍: Manuscripts to the Annals of Surgical Treatment and Research (Ann Surg Treat Res) should be written in English according to the instructions for authors. If the details are not described below, the style should follow the Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publications available at International Committee of Medical Journal Editors (ICMJE) website (http://www.icmje.org).
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信