Hiroshi Kurahara1, Kosei Maemura2, Yuko Mataki2, Masahiko Sakoda2, Satoshi Iino2, Yota Kawasaki2, Takaaki Arigami2, Yoshikazu Uenosono2, Yuko Kijima2, Hiroyuki Shinchi3, Sonshin Takao4, Shoji Natsugoe2. 1. Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan. h-krhr@m3.kufm.kagoshima-u.ac.jp. 2. Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan. 3. Health Sciences, Kagoshima University, Kagoshima, Japan. 4. Frontier Science Research Center, Kagoshima University, Kagoshima, Japan.
Abstract
BACKGROUND: An association between inflammation and patient prognosis has been reported in various types of cancer. The aim of this study was to evaluate the influence of preoperative biliary drainage-related inflammation in patients with biliary tract cancer. METHODS: The clinical data of 97 patients who underwent surgery for extrahepatic bile duct cancer between February 2002 and September 2014 were analyzed, and the prognostic significance of tube-obstructive cholangitis after preoperative biliary drainage and pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) was evaluated. RESULTS: Eighty-four (86.6 %) of the 97 patients underwent ERCP and preoperative biliary drainage. Tube-obstructive cholangitis occurred in 25 cases and post-ERCP pancreatitis in 8 cases. Collectively, 30 patients experienced preoperative biliary drainage-related inflammation consisting of tube-obstructive cholangitis and/or post-ERCP pancreatitis. Drainage-related inflammation was significant risk factor of postoperative complications (P = 0.006), and significant poor predictors of shorter progression-free survival (P = 0.003) and overall survival (OS; P = 0.006) after surgery. In multivariate analysis, drainage-related inflammation was an independent predictor of shorter OS (hazard ratio, 1.924; P = 0.037) after surgery. CONCLUSION: Preoperative biliary drainage-related inflammation was an independent prognostic factor for shorter OS in biliary tract cancer patients.
BACKGROUND: An association between inflammation and patient prognosis has been reported in various types of cancer. The aim of this study was to evaluate the influence of preoperative biliary drainage-related inflammation in patients with biliary tract cancer. METHODS: The clinical data of 97 patients who underwent surgery for extrahepatic bile duct cancer between February 2002 and September 2014 were analyzed, and the prognostic significance of tube-obstructive cholangitis after preoperative biliary drainage and pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) was evaluated. RESULTS: Eighty-four (86.6 %) of the 97 patients underwent ERCP and preoperative biliary drainage. Tube-obstructive cholangitis occurred in 25 cases and post-ERCP pancreatitis in 8 cases. Collectively, 30 patients experienced preoperative biliary drainage-related inflammation consisting of tube-obstructive cholangitis and/or post-ERCP pancreatitis. Drainage-related inflammation was significant risk factor of postoperative complications (P = 0.006), and significant poor predictors of shorter progression-free survival (P = 0.003) and overall survival (OS; P = 0.006) after surgery. In multivariate analysis, drainage-related inflammation was an independent predictor of shorter OS (hazard ratio, 1.924; P = 0.037) after surgery. CONCLUSION: Preoperative biliary drainage-related inflammation was an independent prognostic factor for shorter OS in biliary tract cancerpatients.
Authors: Ashwani K Singal; William A Ross; Praveen Guturu; Gauri R Varadhachary; Milind Javle; Sathya R Jaganmohan; Ramu P Raju; Jason B Fleming; Gottumukala S Raju; Yong-Fang Kuo; Jeffrey H Lee Journal: Dig Dis Sci Date: 2011-07-13 Impact factor: 3.199