Erschienen in:
06.05.2019 | Original Article
A Novel Prognostic Score Combining Preoperative Biliary Drainage and Inflammatory Status for Patients with Periampullary Cancers
verfasst von:
Yuki Fujiwara, MD, PhD, Koichiro Haruki, MD, PhD, Ryoga Hamura, MD, Takashi Horiuchi, MD, PhD, Yoshihiro Shirai, MD, PhD, Kenei Furukawa, MD, PhD, Takeshi Gocho, MD, PhD, FACS, Hiroaki Shiba, MD, PhD, FACS, Katsuhiko Yanaga, MD, PhD, FACS
Erschienen in:
Journal of Gastrointestinal Surgery
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Ausgabe 4/2020
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Abstract
Aims
The benefit of preoperative biliary drainage for patients with operable periampullary cancers is controversial because biliary drainage would activate inflammatory response such as cholangitis. The aim of this study was to identify a novel prognostic score in patients with operable periampullary cancers including pancreatic cancer and extrahepatic distal bile duct cancer with a typical reference to preoperative biliary drainage and inflammatory status.
Methods
Between 2000 and 2015, 246 patients were enrolled in this retrospective study. The patients were divided into four groups of the following three factors; the presence of preoperative biliary drainage, decreased serum albumin value (< 3.5 g dl−1), and increased CR P value (> 1.0 mg dl−1). The relationship between clinicopathological variables and disease-free survival (DFS) as well as over-all survival (OS) was investigated by univariate and multivariate analyses. To compare the sensitivity and specificity among the types of cancer, the area under the receiver operating characteristics curve (AUC) was evaluated in patients with pancreatic cancer and extrahepatic distal bile duct cancer.
Results
In multivariate analysis of DFS and OS, the novel prognostic factor combining preoperative biliary drainage and inflammatory status was an independent risk factor of tumor recurrence and prognosis as well as differentiation of the tumor and resected margin.
Conclusion
The novel prognostic score combining preoperative biliary drainage and inflammatory status may be an independent predictor of tumor recurrence and prognosis in patients with periampullary cancers.