Preoperative Cholangitis and Metastatic Lymph Node Have a Negative Impact on Survival After Resection of Extrahepatic Bile Duct Cancer

• DOI: 10.1007/s00268-012-1594-0
• Publication Date: 2012-04-19T15:53:39Z
• Authors: Jai Young Cho; Ho‐Seong Han; Yoo‐Seok Yoon; Dae Wook Hwang; Kyuwhan Jung; Ji Hoon Kim; Yujin Kwon; Haeryoung Kim
• Keywords: Adult; Aged, 80 and over; Male; Cholangitis; Middle Aged; Prognosis; Survival Analysis; Statistics, Nonparametric; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Bile Duct Neoplasms; Bile Ducts, Extrahepatic; Risk Factors; Lymphatic Metastasis; Humans; Female; Aged; Neoplasm Staging; Proportional Hazards Models

AbstractBackgroundThe significance of the presence of preoperative inflammation for the prognosis of patients with extrahepatic bile duct cancer (BDCA) was evaluated.MethodsThe clinical data of 84 patients who underwent surgery for BDCA from August 2003 to May 2009 were reviewed, and survival analysis was performed. The patients were classified into two groups according to the presence of preoperative cholangitis: Group A had no cholangitis (n = 59), and group B had cholangitis (n = 25).ResultsThere were no differences in sex, mean age, TNM stage, biliary drainage, type of resection, or radicality between the two groups (p > 0.05). The 3‐year disease‐specific survival (DSS) and disease‐free survival (DFS) rates for the group B patients (21.5 and 11.9 %, respectively) were significantly lower than those for the group A patients (66.1 and 57.3 %, respectively; p = 0.013 and 0.001, respectively). The multivariate analysis showed that preoperative inflammation and lymph node metastasis were the independent prognostic factors for both overall survival (OS) [p = 0.021, relative risk (RR) = 2.224 and p = 0.015, RR = 2.367, respectively] and DFS (p = 0.014; RR = 2.192 and p = 0.013; RR = 2.240, respectively). The rates of angiolymphatic and perineural invasion were higher for group B than those for group A (p = 0.016 and 0.030, respectively).ConclusionsThe presence of preoperative inflammation is an independent poor prognostic factor for OS and DFS for patients with BDCA.