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Outcome and evaluation of prognostic factors after pancreaticoduodenectomy for distal cholangiocarcinoma

Byrling, Johannes LU ; Andersson, Roland LU ; Sasor, Agata; Lindell, Gert LU ; Ansari, Daniel LU ; Nilsson, Johan LU and Andersson, Bodil LU (2017) In Annals of Gastroenterology 30(5). p.571-577
Abstract

Background The aim of the present study was to examine the outcomes and prognostic factors after surgery with curative intent for distal cholangiocarcinoma during a modern timespan, in a Swedish tertiary referral center. Methods All patients who underwent pancreaticoduodenectomy for distal cholangiocarcinoma between April 2008 and December 2015 were identified. Survival was estimated using the Kaplan-Meier analysis. Demographic, clinical, laboratory and histopathological data were evaluated for prognostic factors relating to mortality, using univariable and multivariable statistical analysis. Results Fifty-four patients were included. The mean age was 68±8 years and 21 (39%) of the patients were female. Jaundice was present at diagnosis... (More)

Background The aim of the present study was to examine the outcomes and prognostic factors after surgery with curative intent for distal cholangiocarcinoma during a modern timespan, in a Swedish tertiary referral center. Methods All patients who underwent pancreaticoduodenectomy for distal cholangiocarcinoma between April 2008 and December 2015 were identified. Survival was estimated using the Kaplan-Meier analysis. Demographic, clinical, laboratory and histopathological data were evaluated for prognostic factors relating to mortality, using univariable and multivariable statistical analysis. Results Fifty-four patients were included. The mean age was 68±8 years and 21 (39%) of the patients were female. Jaundice was present at diagnosis in 73% of the patients. There was no 90-day mortality. Complications graded as Clavien-Dindo ≥3 occurred in 10 (19%) of the patients. Twenty-eight (52%) received adjuvant therapy. Overall survival rates at 1, 3, and 5 years were 80%, 21%, and 9.2%, respectively. Median survival was 22.2 months. The presence of lymph node metastases was found to be the only independent predictor of survival (hazard ratio 2.88, 95% confidence interval 1.22-6.84; P=0.016). The total number of lymph node metastases, lymph node ratio or total number of resected nodes did not improve the prediction. Conclusions We found that the recurrence rate was higher and the survival poorer after surgery for distal cholangiocarcinoma than has previously been reported. Lymph node status at the time of resection was the most important prognostic factor for survival in the current material.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Distal cholangiocarcinoma, Lymph node metastasis, Prognostic factor, Survival
in
Annals of Gastroenterology
volume
30
issue
5
pages
7 pages
publisher
Hellenic Society of Gastroenterology
external identifiers
  • scopus:85028453992
  • wos:000413650500013
ISSN
1108-7471
DOI
10.20524/aog.2017.0169
language
English
LU publication?
yes
id
52fe2289-b155-405b-a193-18221c0b28a0
date added to LUP
2017-10-04 16:33:32
date last changed
2018-01-16 13:20:48
@article{52fe2289-b155-405b-a193-18221c0b28a0,
  abstract     = {<p>Background The aim of the present study was to examine the outcomes and prognostic factors after surgery with curative intent for distal cholangiocarcinoma during a modern timespan, in a Swedish tertiary referral center. Methods All patients who underwent pancreaticoduodenectomy for distal cholangiocarcinoma between April 2008 and December 2015 were identified. Survival was estimated using the Kaplan-Meier analysis. Demographic, clinical, laboratory and histopathological data were evaluated for prognostic factors relating to mortality, using univariable and multivariable statistical analysis. Results Fifty-four patients were included. The mean age was 68±8 years and 21 (39%) of the patients were female. Jaundice was present at diagnosis in 73% of the patients. There was no 90-day mortality. Complications graded as Clavien-Dindo ≥3 occurred in 10 (19%) of the patients. Twenty-eight (52%) received adjuvant therapy. Overall survival rates at 1, 3, and 5 years were 80%, 21%, and 9.2%, respectively. Median survival was 22.2 months. The presence of lymph node metastases was found to be the only independent predictor of survival (hazard ratio 2.88, 95% confidence interval 1.22-6.84; P=0.016). The total number of lymph node metastases, lymph node ratio or total number of resected nodes did not improve the prediction. Conclusions We found that the recurrence rate was higher and the survival poorer after surgery for distal cholangiocarcinoma than has previously been reported. Lymph node status at the time of resection was the most important prognostic factor for survival in the current material.</p>},
  author       = {Byrling, Johannes and Andersson, Roland and Sasor, Agata and Lindell, Gert and Ansari, Daniel and Nilsson, Johan and Andersson, Bodil},
  issn         = {1108-7471},
  keyword      = {Distal cholangiocarcinoma,Lymph node metastasis,Prognostic factor,Survival},
  language     = {eng},
  number       = {5},
  pages        = {571--577},
  publisher    = {Hellenic Society of Gastroenterology},
  series       = {Annals of Gastroenterology},
  title        = {Outcome and evaluation of prognostic factors after pancreaticoduodenectomy for distal cholangiocarcinoma},
  url          = {http://dx.doi.org/10.20524/aog.2017.0169},
  volume       = {30},
  year         = {2017},
}