Evaluation of the utility of prognostic models for patients with resected hilar cholangiocarcinoma. Issue 10 (October 2019)

• Record Type: Journal Article
• Authors: Bird, Nicholas T.E.; Manu, Nichola; Quinn, Leonard; Needham, Alex; Jones, Robert; Fenwick, Stephen; Poston, Graeme; Palmer, Daniel; Malik, Hassan
• Is Part Of: HPB. Volume 21:Issue 10(2019)
• Page Start: 1376
• Page End: 1384
• Publication Date: 2019-10
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1016/j.hpb.2019.02.014
• Languages: English
• ISSNs: 1365-182X

Abstract

Abstract: Background: Several prognostic systems have been proposed to guide management strategies post-resection for patients with hilar cholangiocarcinoma. The objective of this study was to evaluate the efficacy of these conventional prognostic models, with respect to Overall Survival (OS), on patients in a modern single-centre resectional cohort. Method: Patients diagnosed with hilar cholangiocarcinoma, referred to a supra-regional tertiary referral centre between February 2009 and February 2016, were retrospectively analysed from a prospectively held database linked to Hospital Episode Statistics and Somerset Cancer Registry data. Results: Two-hundred and one patients were assessed for suitability for surgery. Eighty-three (41%) patients considered to have potentially resectable disease underwent surgical assessment of resectability. Fifty-six (68%) patients proceeded to resection. Multivariate analysis demonstrated that pre-operative Serum CA 19-9 (p = 0.007), Radiological Arterial Involvement (p = 0.005) and Amsterdam Medical Centre (AMC) prognostic model score (p = 0.032) retained significance in association with OS. Multivariate models developed from this cohort out-performed the conventional prognostic systems for OS. Conclusion: The cohort-derived multivariate models demonstrated significantly improved prognostic capability compared to conventional systems in explaining OS.