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Journal of Gastrointestinal Surgery

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01-03-2019 | Original Article

Clinical Value of Inflammation-Based Prognostic Scores to Predict the Resectability of Hyperbilirubinemia Patients with Potentially Resectable Hilar Cholangiocarcinoma

Authors: Hai-Jie Hu, Yan-Wen Jin, Rong-Xing Zhou, Wen-Jie Ma, Qin Yang, Jun-Ke Wang, Fei Liu, Nan-Sheng Cheng, Fu-Yu Li

Published in: Journal of Gastrointestinal Surgery | Issue 3/2019

Abstract

Background

We aimed to examine whether inflammation-based prognostic scores could predict tumor resectability in a cohort of hilar cholangiocarcinoma patients with preoperative hyperbilirubinemia. We also sought to investigate the prognostic factors associated with overall survival in the subgroup of patients with an R0 resection.

Methods

A total of 173 patients with potentially resectable hilar cholangiocarcinoma, as judged by radiological examinations, were included. The potential relationship of the Glasgow prognostic score (GPS), modified GPS, platelet lymphocyte ratio (PLR), neutrophil lymphocyte ratio (NLR), prognostic nutritional index (PNI), and prognostic index (PI) with tumor resectability were investigated using univariate and multivariate analysis.

Results

Among the 173 patients, 134 had R0 resection margins. Univariate analysis identified that patients with PLR ≥ 150, NLR ≥ 3, PNI ≥ 45, GPS (0.1/2), modified GPS (0.1/2), preoperative CA 125 > 35 U/mL, and a tumor size ≥ 3 cm were more likely to have unresectable tumors. Multivariate analysis indicated that tumor size ≥ 3 cm (OR = 2.422, 95% CI: 1.053–5.573; P = 0.037), PLR ≥ 150 (OR = 3.324, 95% CI: 1.143–9.667; P = 0.027), preoperative CA 125 > 35 U/mL (OR = 3.184, 95% CI: 1.316–7.704; P = 0.010), and GPS (0.1/2) (OR = 2.440, 95% CI: 1.450–4.107; P = 0.001) were independent factors associated with tumor resectability. In selected patients with an R0 resection in this cohort, nodal status (P = 0.010) and tumor differentiation (P = 0.025) were predictive of poor survival outcome.

Conclusion

Patients with higher GPS, CA 125, and PLR levels, and a larger tumor size, tend to have unresectable tumors even if they were judged as potentially resectable using preoperative radiological examinations.

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Title: Clinical Value of Inflammation-Based Prognostic Scores to Predict the Resectability of Hyperbilirubinemia Patients with Potentially Resectable Hilar Cholangiocarcinoma
Authors: Hai-Jie Hu
Yan-Wen Jin
Rong-Xing Zhou
Wen-Jie Ma
Qin Yang
Jun-Ke Wang
Fei Liu
Nan-Sheng Cheng
Fu-Yu Li
Publication date: 01-03-2019
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 3/2019
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-018-3892-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical Value of Inflammation-Based Prognostic Scores to Predict the Resectability of Hyperbilirubinemia Patients with Potentially Resectable Hilar Cholangiocarcinoma

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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