TITLE

Comorbidity negatively influences prognosis in patients with extrahepatic cholangiocarcinoma

AUTHOR(S)
Fernández-Ruiz, Mario; Guerra-Vales, Juan-Manuel; Colina-Ruizdelgado, Francisco
PUB. DATE
November 2009
SOURCE
World Journal of Gastroenterology;11/14/2009, Vol. 15 Issue 42, p5279
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
AIM: To study the outcome and prognostic factors in a series of patients with extrahepatic cholangiocarcinoma and determine the impact of comorbidity on survival. METHODS: A retrospective analysis of 68 patients with extrahepatic cholangiocarcinoma (perihilar, n = 37; distal, n = 31) seen at a single tertiary-care institution during the period 1999-2003 was performed. Data on presentation, management, and outcome were assessed by chart review. Pathologic confirmation was obtained in 37 cases (54.4%). Comorbidity was evaluated by using the Charlson comorbidity index (CCI). RESULTS: Mean age at diagnosis was 73.4 ± 11.5 years. Jaundice was the most common symptom presented (86.8%). Median CCI score was 1 (range, 0 to 4). Nineteen patients (27.9%) underwent tumor resection. Palliative biliary drainage was performed in 39 patients (57.4%), and 6 patients (8.8%) received only best supportive care. Tumor-free margin status (R0) was achieved in 15 cases (78.9% of resection group). Baseline serum carbohydrate antigen 19-9 (CA 19-9) level was revealed to be an independent predictor of surgical treatment (P = 0.026). Overall median survival was 3.1 ± 0.9 mo, with 1- and 2-year survival rates of 21% and 7%, respectively. In the univariate analysis, tumor resection, CCI score, and serum CA 19-9 levels correlated significantly with outcome. In the multivariate analysis, only resection (HR 0.10; 95% CI, 0.02-0.51, P = 0.005) and a CCI score ≤ 2 (HR 3.36; 95% CI, 1.0-10.9, P = 0.045) were found to independently predict survival. CONCLUSION: Tumor resection and comorbidity emerged as significant prognostic variables in extrahepatic cholangiocarcinoma. Comorbidity evaluation instruments should be applied in the clinical management of such patients.
ACCESSION #
45308160

 

Related Articles

  • A huge intraductal papillary mucinous carcinoma of the bile duct treated by right trisectionectomy with caudate lobectomy.  // World Journal of Surgical Oncology;2009, Vol. 7, p1 

    Background: Because intraductal papillary mucinous neoplasm of the bile duct (IPMN-B) is believed to show a better clinical course than non-papillary biliary neoplasms, it is important to make a precise diagnosis and to perform complete surgical resection. Case presentation: We herein report a...

  • Comparative Analysis of Left- Versus Right-sided Resection in Klatskin Tumor Surgery: can Lesion Side be Considered a Prognostic Factor? Ratti, Francesca; Cipriani, Federica; Piozzi, Guglielmo; Catena, Marco; Paganelli, Michele; Aldrighetti, Luca // Journal of Gastrointestinal Surgery;Jul2015, Vol. 19 Issue 7, p1324 

    Background: Achievement of negative margins is the goal of curative intent surgery for hilar cholangiocarcinoma. This study analyzed factors affecting survival in hilar cholangiocarcinoma patients and compared short- and long-term outcomes of left- and right-sided resections. Methods: One...

  • Low preoperative serum albumin in colon cancer: a risk factor for poor outcome. Lai, Cheng-Chou; You, Jeng-Fu; Yeh, Chien-Yuh; Chen, Jinn-Shiun; Tang, Reiping; Wang, Jeng-Yi; Chin, Chih-Chien // International Journal of Colorectal Disease;Apr2011, Vol. 26 Issue 4, p473 

    Objective: The number of colon cancer patients is increasing worldwide. Malnutrition and comorbidities are frequently associated with these patients. The relationships between the preoperative malnutrition and the outcomes of colon cancer patients are unclear; this study aimed to clarify these...

  • Cholangiocarcinoma: A 7-year experience at a single center in Greece. Alexopoulou, Alexandra; Soultati, Aspasia; Dourakis, Spyros P.; Vasilieva, Larissa; Archimandritis, Athanasios J.; Marin, Jose J. G. // World Journal of Gastroenterology;10/28/2008, Vol. 14 Issue 40, p6213 

    AIM: To evaluate survival rate and clinical outcome of cholangiocarcinoma. METHODS: The medical records of 34 patients with cholangiocarcinoma, seen at a single hospital between the years 1999-2006, were retrospectively reviewed. RESULTS: Thirty-four patients with a median age of 75 years were...

  • The Outcome of Ipsilateral Hemihepatectomy in Mucin-Producing Bile Duct Tumors. Yang, Xin-wei; Yang, Jue; Li, Liang; Yan, Xing-zhou; Zhang, Bao-hua; Shen, Feng; Wu, Meng-chao // PLoS ONE;Apr2014, Vol. 9 Issue 4, p1 

    Background: Mucin-producing bile duct tumors (MPBTs) are unusual, and we present our experience with nine surgically proven cases. Methods: Between November 2002 and November 2012, 9 patients with surgically proven MPBTs (including history of relevant hepatobiliary surgery in 6 patients) were...

  • Hemoglobin level predicts outcome for vulvar cancer patients independent of GLUT-1 and CA-IX expression in tumor tissue. Nieuwenhof, Hedwig; Hullu, Joanne; Kaanders, Johannes; Bulten, Johan; Massuger, Leon; Kempen, Léon; van de Nieuwenhof, Hedwig P; de Hullu, Joanne A; Kaanders, Johannes H A M; Massuger, Leon F A G; van Kempen, Léon C L T // Virchows Archiv;Dec2010, Vol. 457 Issue 6, p693 

    Intratumoral hypoxia has been associated with poor prognosis in several solid tumors. The aim of this study was to determine whether the hypoxia-associated markers glucose transporter (GLUT)-1 and carbonic anhydrase (CA)-IX expression and preoperative hemoglobin (Hb) levels correlate with...

  • Partial nephrectomy for hilar tumors: comparison of conventional open and robot-assisted approaches. Miyake, Hideaki; Hinata, Nobuyuki; Imai, Satoshi; Furukawa, Junya; Tanaka, Kazushi; Fujisawa, Masato // International Journal of Clinical Oncology;Aug2015, Vol. 20 Issue 4, p808 

    Background: To characterize clinical advantages in robot-assisted partial nephrectomy (RAPN) for targeting renal hilar tumors, and compare them with those of open PN (OPN). Methods: This study included 31 consecutive patients with renal hilar tumors, consisting of 15 and 16 who received OPN and...

  • Isolated recurrence of distal adenocarcinoma of the extrahepatic bile duct on a draining sinus scar after curative resection: Case Report and review of the literature.  // World Journal of Surgical Oncology;2009, Vol. 7, p1 

    Background: Surgical resection remains the gold standard for the treatment of localized adenocarcinoma of the extrahepatic bile ducts. Yet, treatment of loco-regional recurrences is not well defined. Case Presentation: We present an unusual case of distal adenocarcinoma of the extrahepatic bile...

  • MTSS1 is an independent prognostic biomarker for survival in intrahepatic cholangiocarcinoma patients. Wei Shi; Gulimire Hasimu; Yan Wang; Ning Li; Mingquan Chen; Hao Zhang // American Journal of Translational Research;2015, Vol. 7 Issue 10, p1974 

    MTSS1 is a possible metastasis suppressor which has been proved to play a key role in metastasis of various tumors, yet its role in intrahepatic cholangiocarcinoma (ICC) remains unclear. In present study, we reported detection of MTSS1 expression in ICC and explored its clinical significances....

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics