Inflammation-based prognostic score is a useful predictor of postoperative outcome in patients with extrahepatic cholangiocarcinoma

• Published in: Journal of hepato-biliary-pancreatic sciences Vol. 20; no. 3; pp. 389 - 395
• Main Authors: Oshiro, Yukio, Sasaki, Ryoko, Fukunaga, Kiyoshi, Kondo, Tadashi, Oda, Tatsuya, Takahashi, Hideto, Ohkohchi, Nobuhiro
• Format: Journal Article
• Language: English
• Published: Japan Blackwell Publishing Ltd 01.03.2013; Springer Japan; Wiley Subscription Services, Inc
• Subjects: Abdominal Surgery; Adult; Aged; Aged, 80 and over; albumin; Bile Duct Neoplasms - pathology; Bile Duct Neoplasms - surgery; Bile Ducts, Extrahepatic; Biomarkers, Tumor - metabolism; C-reactive protein; C-Reactive Protein - metabolism; Cholangiocarcinoma - pathology; Cholangiocarcinoma - surgery; Drainage - methods; extrahepatic cholangiocarcinoma; Female; Gastroenterology; glasgow prognostic score; Hepatology; Humans; Hypoalbuminemia - metabolism; Inflammation - pathology; Lymph Node Excision; Lymphatic Metastasis; Male; Medical prognosis; Medicine; Medicine & Public Health; Middle Aged; Original Article; Predictive Value of Tests; Prognosis; Proportional Hazards Models; Retrospective Studies; Surgical Oncology; Survival Rate; systemic inflammatory response; Glasgow prognostic score; Albumin; Systemic inflammatory response; Extrahepatic cholangiocarcinoma; C-reactive protein
• ISSN: 1868-6974; 1868-6982
• DOI: 10.1007/s00534-012-0550-6

Background/purpose Recent studies have revealed that the Glasgow prognostic score (GPS), an inflammation-based prognostic score, is useful for predicting outcome in a variety of cancers. This study sought to investigate the significance of GPS for prognostication of patients who underwent surgery with extrahepatic cholangiocarcinoma. Methods We retrospectively analyzed a total of 62 patients who underwent resection for extrahepatic cholangiocarcinoma. We calculated the GPS as follows: patients with both an elevated C-reactive protein (>10 mg/L) and hypoalbuminemia (<35 g/L) were allocated a score of 2; patients with one or none of these abnormalities were allocated a score of 1 or 0, respectively. Prognostic significance was analyzed by the log-rank test and a Cox proportional hazards model. Results Overall survival rate was 25.5 % at 5 years for all 62 patients. Venous invasion ( p  = 0.01), pathological primary tumor category ( p  = 0.013), lymph node metastasis category ( p  < 0.001), TNM stage ( p  < 0.001), and GPS ( p  = 0.008) were significantly associated with survival by univariate analysis. A Cox model demonstrated that increased GPS was an independent predictive factor with poor prognosis. Conclusions The preoperative GPS is a useful predictor of postoperative outcome in patients with extrahepatic cholangiocarcinoma.