Hasan Ahmad Al-Saffar, Nicolai Schultz, Peter Nørrgaard Larsen, Eva Fallentin, Gro Linno Willemoe, Diana Elena Renteria Ramirez, Lucas Alexander Knøfler, Hans-Christian Pommergaard
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The 1-, 3- and 5-year OS rates were 86.1%, 56.5% and 32.6% respectively. The 1-, 3- and 5-year DFS rates were 67.7%, 40.0% and 26.8%, respectively. Portal vein embolization (PVE) (HR 4.52 [CI 1.66-12.27], <i>p</i> = 0.003), lymph node metastasis (LNM) (HR 6.37 [CI 2.06-19.67], <i>p</i> = 0.001) and Clavien-Dindo (CD) ≥3a (HR 2.83 [CI 1.43-5.56], <i>p</i> = 0.002) were associated with inferior OS. Clavien-Dindo (CD) ≥3a (HR 2.10 [CI 1.05-4.22], <i>p</i> = 0.03) and T-stage >2 (HR 2.36 [CI 1.01, 5.05], <i>p</i> = 0.04) were associated with inferior and superior DFS, respectively.</p><p><strong>Conclusion: </strong>PVE, T-stage >2, LNM and CD ≥ III were associated with worse prognosis in resected pCCA. Research is needed to improve pre-operative detection of oncological features and patients with risk of major surgical complications.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-8"},"PeriodicalIF":1.6000,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Postoperative factors predicting outcomes in patients with Perihilar cholangiocarcinoma undergoing curative resection-a 10-year single-center experience.\",\"authors\":\"Hasan Ahmad Al-Saffar, Nicolai Schultz, Peter Nørrgaard Larsen, Eva Fallentin, Gro Linno Willemoe, Diana Elena Renteria Ramirez, Lucas Alexander Knøfler, Hans-Christian Pommergaard\",\"doi\":\"10.1080/00365521.2024.2443515\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Perihilar cholangiocarcinoma (pCCA) has a 5-year overall survival (OS) ranging from 10-40%, following resection. However, prognostic models for postoperative outcomes are limited by long study timespan and variations in work-up. We investigated postoperative outcomes in patients resected for pCCA in a high-volume center with standardized work-up.</p><p><strong>Method: </strong>Patients resected with confirmed pCCA, between 2013 and 2023, were included. Cox-regression investigated association between postoperative factors and OS as well as disease-free survival (DFS).</p><p><strong>Results: </strong>Totally, 65 patients were resected for pCCA. The 1-, 3- and 5-year OS rates were 86.1%, 56.5% and 32.6% respectively. The 1-, 3- and 5-year DFS rates were 67.7%, 40.0% and 26.8%, respectively. Portal vein embolization (PVE) (HR 4.52 [CI 1.66-12.27], <i>p</i> = 0.003), lymph node metastasis (LNM) (HR 6.37 [CI 2.06-19.67], <i>p</i> = 0.001) and Clavien-Dindo (CD) ≥3a (HR 2.83 [CI 1.43-5.56], <i>p</i> = 0.002) were associated with inferior OS. Clavien-Dindo (CD) ≥3a (HR 2.10 [CI 1.05-4.22], <i>p</i> = 0.03) and T-stage >2 (HR 2.36 [CI 1.01, 5.05], <i>p</i> = 0.04) were associated with inferior and superior DFS, respectively.</p><p><strong>Conclusion: </strong>PVE, T-stage >2, LNM and CD ≥ III were associated with worse prognosis in resected pCCA. 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引用次数: 0
摘要
背景：肝门周围胆管癌（pCCA）切除后的5年总生存率（OS）为10-40%。然而，术后预后模型受到长期研究时间跨度和随访变化的限制。我们在一个标准化检查的大容量中心调查了因pCCA切除的患者的术后结果。方法：纳入2013年至2023年期间确诊pCCA切除的患者。cox回归研究了术后因素与OS和无病生存期（DFS）之间的关系。结果：共65例患者因pCCA被切除。1年、3年和5年总生存率分别为86.1%、56.5%和32.6%。1年、3年和5年DFS分别为67.7%、40.0%和26.8%。门静脉栓塞（PVE） （HR 4.52 [CI 1.66 ~ 12.27], p = 0.003）、淋巴结转移（LNM） （HR 6.37 [CI 2.06 ~ 19.67], p = 0.001）、Clavien-Dindo (CD)≥3a （HR 2.83 [CI 1.43 ~ 5.56], p = 0.002）与不良OS相关。Clavien-Dindo (CD)≥3a （HR 2.10 [CI 1.05-4.22], p = 0.03）和t期>2 （HR 2.36 [CI 1.01, 5.05], p = 0.04）分别与DFS的低度和优度相关。结论：PVE、t期>2、LNM、CD≥III与pCCA切除后预后较差相关。需要研究提高术前对肿瘤特征和主要手术并发症风险患者的检测。
Postoperative factors predicting outcomes in patients with Perihilar cholangiocarcinoma undergoing curative resection-a 10-year single-center experience.
Background: Perihilar cholangiocarcinoma (pCCA) has a 5-year overall survival (OS) ranging from 10-40%, following resection. However, prognostic models for postoperative outcomes are limited by long study timespan and variations in work-up. We investigated postoperative outcomes in patients resected for pCCA in a high-volume center with standardized work-up.
Method: Patients resected with confirmed pCCA, between 2013 and 2023, were included. Cox-regression investigated association between postoperative factors and OS as well as disease-free survival (DFS).
Results: Totally, 65 patients were resected for pCCA. The 1-, 3- and 5-year OS rates were 86.1%, 56.5% and 32.6% respectively. The 1-, 3- and 5-year DFS rates were 67.7%, 40.0% and 26.8%, respectively. Portal vein embolization (PVE) (HR 4.52 [CI 1.66-12.27], p = 0.003), lymph node metastasis (LNM) (HR 6.37 [CI 2.06-19.67], p = 0.001) and Clavien-Dindo (CD) ≥3a (HR 2.83 [CI 1.43-5.56], p = 0.002) were associated with inferior OS. Clavien-Dindo (CD) ≥3a (HR 2.10 [CI 1.05-4.22], p = 0.03) and T-stage >2 (HR 2.36 [CI 1.01, 5.05], p = 0.04) were associated with inferior and superior DFS, respectively.
Conclusion: PVE, T-stage >2, LNM and CD ≥ III were associated with worse prognosis in resected pCCA. Research is needed to improve pre-operative detection of oncological features and patients with risk of major surgical complications.
期刊介绍：
The Scandinavian Journal of Gastroenterology is one of the most important journals for international medical research in gastroenterology and hepatology with international contributors, Editorial Board, and distribution
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