BACKGROUND: Tumor location of extrahepatic cholangiocarcinoma (CCA) might influence survival after resection. METHODS: A consecutive series of 175 patients who had undergone a potentially curative resection of extrahepatic CCA was analyzed. We calculated concordance indices of different constructed prognostic models for survival including TNM (tumour-node-metastasis) staging and developed a nomogram of the most sensitive model. RESULTS: Overall cancer-specific survival rates were 83%, 58%, and 26% at 1, 2, and 5 years, respectively. Cancer-specific survival according to location was 42% for proximal, 23% for mid, and 19% for distal CCA after 5 years. Tumor location was not an independent significant predictor (P = 0.06). A prognostic model using all potential prognostic variables predicted survival better compared with TNM staging (concordance index 0.65 versus 0.63). A reduced model containing only lymph node status, microscopically residual tumor status, and tumor differentiation grade, also outperformed TNM staging (concordance index 0.66). CONCLUSIONS: Tumor location of extrahepatic CCA does not independently predict cancer-specific survival after resection. We developed a nomogram, based on a prognostic model with lymph node status, microscopically residual tumor status of resection margins, and tumor differentiation grade, that predicted survival better than TNM staging.
BACKGROUND:Tumor location of extrahepatic cholangiocarcinoma (CCA) might influence survival after resection. METHODS: A consecutive series of 175 patients who had undergone a potentially curative resection of extrahepatic CCA was analyzed. We calculated concordance indices of different constructed prognostic models for survival including TNM (tumour-node-metastasis) staging and developed a nomogram of the most sensitive model. RESULTS: Overall cancer-specific survival rates were 83%, 58%, and 26% at 1, 2, and 5 years, respectively. Cancer-specific survival according to location was 42% for proximal, 23% for mid, and 19% for distal CCA after 5 years. Tumor location was not an independent significant predictor (P = 0.06). A prognostic model using all potential prognostic variables predicted survival better compared with TNM staging (concordance index 0.65 versus 0.63). A reduced model containing only lymph node status, microscopically residual tumor status, and tumor differentiation grade, also outperformed TNM staging (concordance index 0.66). CONCLUSIONS:Tumor location of extrahepatic CCA does not independently predict cancer-specific survival after resection. We developed a nomogram, based on a prognostic model with lymph node status, microscopically residual tumor status of resection margins, and tumor differentiation grade, that predicted survival better than TNM staging.
Authors: Annemiek M Dekker; Jimme K Wiggers; Robert J Coelen; Rowan F van Golen; Marc G H Besselink; Olivier R C Busch; Joanne Verheij; Markus W Hollmann; Thomas M van Gulik Journal: HPB (Oxford) Date: 2016-01-06 Impact factor: 3.647
Authors: B Groot Koerkamp; J K Wiggers; M Gonen; A Doussot; P J Allen; M G H Besselink; L H Blumgart; O R C Busch; M I D'Angelica; R P DeMatteo; D J Gouma; T P Kingham; T M van Gulik; W R Jarnagin Journal: Ann Oncol Date: 2015-06-30 Impact factor: 32.976
Authors: Caitlin Hester; Ibrahim Nassour; Beverley Adams-Huet; Mathew Augustine; Michael A Choti; Rebecca M Minter; John C Mansour; Patricio M Polanco; Matthew R Porembka; Sam C Wang; Adam C Yopp Journal: J Gastrointest Surg Date: 2018-07-20 Impact factor: 3.452
Authors: Sophie Duignan; Donal Maguire; Chamarajanagar S Ravichand; Justin Geoghegan; Emir Hoti; David Fennelly; John Armstrong; Kathy Rock; Helen Mohan; Oscar Traynor Journal: HPB (Oxford) Date: 2013-04-18 Impact factor: 3.647