Relevant prognostic factors influencing outcome of patients after surgical resection of distal cholangiocarcinoma
Abstract Background Distal cholangiocarcinoma (DCC) is a rare but over the last decade increasing malignancy and is associated with poor prognosis. According to the present knowledge curative surgery is the only chance for long term survival. This study was performed to evaluate prognostic factors f...
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| Format: | Article |
| Language: | English |
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BMC
2018-08-01
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| Series: | BMC Surgery |
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| Online Access: | http://link.springer.com/article/10.1186/s12893-018-0384-5 |
| _version_ | 1828414117206032384 |
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| author | Oliver Beetz Michael Klein Harald Schrem Jill Gwiasda Florian W. R. Vondran Felix Oldhafer Sebastian Cammann Jürgen Klempnauer Karl J. Oldhafer Moritz Kleine |
| author_facet | Oliver Beetz Michael Klein Harald Schrem Jill Gwiasda Florian W. R. Vondran Felix Oldhafer Sebastian Cammann Jürgen Klempnauer Karl J. Oldhafer Moritz Kleine |
| author_sort | Oliver Beetz |
| collection | DOAJ |
| description | Abstract Background Distal cholangiocarcinoma (DCC) is a rare but over the last decade increasing malignancy and is associated with poor prognosis. According to the present knowledge curative surgery is the only chance for long term survival. This study was performed to evaluate prognostic factors for the outcome of patients undergoing curative surgery for distal cholangiocarcinoma. Methods 75 patients who underwent surgery between January 2000 and December 2014 for DCC in curative intention were analysed retrospectively. Potential prognostic factors for survival were investigated including the extent of surgery using purposeful selection of covariates in multivariable Cox regression modeling. Results Preoperative biliary stenting (Hazard ratio (HR): 2.530; 95%-CI: 1.146–6.464, p = 0.020), the extent of surgery in case of positive histological venous invasion (HR: 1.209; 95%-CI: 1.017–1.410, p = 0.032), lymph node staging (HR: 2.183; 95%-CI: 1.250–3.841, p = 0.006), perineural invasion (HR: 2.118; 95%-CI: 1.147–4.054, p = 0.016) and postoperative complications graded in points according to Clavien-Dindo (HR: 1.395; 95%-CI: 1.148–1.699, p = 0.001) were indentified as independent significant risk factors for survival. Patients receiving preoperative biliary stenting showed prolonged duration between onset of symptoms and date of operation (p = 0.048). Conclusions Preoperative biliary stenting reduces survival possibly due to delayed surgery. The extent of surgery is not an independent risk factor for survival except for patients with concomitant histological venous invasion. Oncological factors and postoperative surgical complications are independent prognostic factors for survival. |
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| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-12-10T13:21:32Z |
| publishDate | 2018-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-250dedd15da6492db3b515ec5cb4a55e2022-12-22T01:47:18ZengBMCBMC Surgery1471-24822018-08-0118111010.1186/s12893-018-0384-5Relevant prognostic factors influencing outcome of patients after surgical resection of distal cholangiocarcinomaOliver Beetz0Michael Klein1Harald Schrem2Jill Gwiasda3Florian W. R. Vondran4Felix Oldhafer5Sebastian Cammann6Jürgen Klempnauer7Karl J. Oldhafer8Moritz Kleine9Department of General, Visceral and Transplant Surgery, Medizinische Hochschule HannoverDepartment of General, Visceral and Transplant Surgery, Medizinische Hochschule HannoverDepartment of General, Visceral and Transplant Surgery, Medizinische Hochschule HannoverCore Facility Quality Management Transplantation, Integrated Research and Treatment Center Transplantation (IFB-Tx), Hannover Medical SchoolDepartment of General, Visceral and Transplant Surgery, Medizinische Hochschule HannoverDepartment of General, Visceral and Transplant Surgery, Medizinische Hochschule HannoverDepartment of General, Visceral and Transplant Surgery, Medizinische Hochschule HannoverDepartment of General, Visceral and Transplant Surgery, Medizinische Hochschule HannoverDepartment of General, Visceral and Oncological Surgery, Asklepios Klinik BarmbekDepartment of General, Visceral and Transplant Surgery, Medizinische Hochschule HannoverAbstract Background Distal cholangiocarcinoma (DCC) is a rare but over the last decade increasing malignancy and is associated with poor prognosis. According to the present knowledge curative surgery is the only chance for long term survival. This study was performed to evaluate prognostic factors for the outcome of patients undergoing curative surgery for distal cholangiocarcinoma. Methods 75 patients who underwent surgery between January 2000 and December 2014 for DCC in curative intention were analysed retrospectively. Potential prognostic factors for survival were investigated including the extent of surgery using purposeful selection of covariates in multivariable Cox regression modeling. Results Preoperative biliary stenting (Hazard ratio (HR): 2.530; 95%-CI: 1.146–6.464, p = 0.020), the extent of surgery in case of positive histological venous invasion (HR: 1.209; 95%-CI: 1.017–1.410, p = 0.032), lymph node staging (HR: 2.183; 95%-CI: 1.250–3.841, p = 0.006), perineural invasion (HR: 2.118; 95%-CI: 1.147–4.054, p = 0.016) and postoperative complications graded in points according to Clavien-Dindo (HR: 1.395; 95%-CI: 1.148–1.699, p = 0.001) were indentified as independent significant risk factors for survival. Patients receiving preoperative biliary stenting showed prolonged duration between onset of symptoms and date of operation (p = 0.048). Conclusions Preoperative biliary stenting reduces survival possibly due to delayed surgery. The extent of surgery is not an independent risk factor for survival except for patients with concomitant histological venous invasion. Oncological factors and postoperative surgical complications are independent prognostic factors for survival.http://link.springer.com/article/10.1186/s12893-018-0384-5Distal bile duct cancerExtended surgeryVenous invasionPreoperative biliary stenting |
| spellingShingle | Oliver Beetz Michael Klein Harald Schrem Jill Gwiasda Florian W. R. Vondran Felix Oldhafer Sebastian Cammann Jürgen Klempnauer Karl J. Oldhafer Moritz Kleine Relevant prognostic factors influencing outcome of patients after surgical resection of distal cholangiocarcinoma BMC Surgery Distal bile duct cancer Extended surgery Venous invasion Preoperative biliary stenting |
| title | Relevant prognostic factors influencing outcome of patients after surgical resection of distal cholangiocarcinoma |
| title_full | Relevant prognostic factors influencing outcome of patients after surgical resection of distal cholangiocarcinoma |
| title_fullStr | Relevant prognostic factors influencing outcome of patients after surgical resection of distal cholangiocarcinoma |
| title_full_unstemmed | Relevant prognostic factors influencing outcome of patients after surgical resection of distal cholangiocarcinoma |
| title_short | Relevant prognostic factors influencing outcome of patients after surgical resection of distal cholangiocarcinoma |
| title_sort | relevant prognostic factors influencing outcome of patients after surgical resection of distal cholangiocarcinoma |
| topic | Distal bile duct cancer Extended surgery Venous invasion Preoperative biliary stenting |
| url | http://link.springer.com/article/10.1186/s12893-018-0384-5 |
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