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BMC Surgery
Published in: BMC Surgery 1/2018

Open Access 01-12-2018 | Research article

Relevant prognostic factors influencing outcome of patients after surgical resection of distal cholangiocarcinoma

Authors: Oliver Beetz, Michael Klein, Harald Schrem, Jill Gwiasda, Florian W. R. Vondran, Felix Oldhafer, Sebastian Cammann, Jürgen Klempnauer, Karl J. Oldhafer, Moritz Kleine

Published in: BMC Surgery | Issue 1/2018

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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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Metadata
Title
Relevant prognostic factors influencing outcome of patients after surgical resection of distal cholangiocarcinoma
Authors
Oliver Beetz
Michael Klein
Harald Schrem
Jill Gwiasda
Florian W. R. Vondran
Felix Oldhafer
Sebastian Cammann
Jürgen Klempnauer
Karl J. Oldhafer
Moritz Kleine
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2018
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-018-0384-5

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