Introduction
Methods
Study design
Patient selection
Cytology samples
Surgery
Outcome measures
Positive PWC (n = 11) | Negative PWC (n = 220) | P value | |
---|---|---|---|
Preoperative factors | |||
Age (median, range) | 71(46–85) | 72 (18–92) | 0.899 |
Gender (male / female), n | 4/7 | 138/82 | 0.080 |
BMI (median, range) | 23.3 (17.4–27.4) | 22.9 (15.5–30.1) | 0.837 |
Type of carcinoma, n (%) | 0.755 | ||
ICC GBC HC DC | 3 (27.3%) 2 (18.2%) 4 (36.4%) 2 (18.2%) | 38 (17.3%) 53 (24.1%) 68 (30.9%) 61 (27.7%) | |
Preoperative biliary drainage | 0.099 | ||
EBD /PTBD / No drainage, n | 9/1/1 | 147/4/69 | |
Laboratory data (median, range) | |||
Hb (g/dL) | 11.6 (8.6–13.4) | 11.9 (7.0–17.5) | 0.269 |
Alb (g/dL) | 3.5 (3.0–4.2) | 3.6 (2.5–4.9) | 0.225 |
ChE (U/L) | 199 (103–321) | 228 (190–553) | 0.443 |
T-cho (mg/dL) | 156 (99–207) | 180 (67–472) | 0.160 |
T.bil (mg/dL) | 0.9 (0.5–3.1) | 0.8 (0.3–5.8) | 0.412 |
Cr (mg/dL) | 0.62 (0.48–0.88) | 0.74 (0.29–7.68) | 0.148 |
CRP | 0.26 (0.04–2.38) | 0.23 (0.01–18.1) | 0.892 |
CA19-9 (U/mL) | 470 (4–4207) | 43 (1–24,164) | 0.009 |
DUPAN-2 | 160 (56–1800) | 110 (24–140,000) | 0.176 |
Surgery-related factors | |||
Surgical procedure, n (%) | 0.527 | ||
Hepatectomy with BDR | 5 (45.5%) | 90 (40.9%) | |
Hepatectomy | 2 (18.2%) | 23 (10.5%) | |
PD | 2 (18.2%) | 71 (32.3%) | |
Cholecystectomy* with BDR | 2 (18.2%) | 19 (8.6%) | |
Cholecystectomy* | 0 (0%) | 17 (7.7%) | |
Concomitant vascular resection | |||
HAR, n (%) | 1 (9.1%) | 20 (9.1%) | 1.000 |
PVR, n (%) | 2 (18.2%) | 25 (11.4%) | 0.492 |
Operation time (min) (median, range) | 349 (263–474) | 368 (70–752) | 0.485 |
Blood loss (mL) (median, range) | 342 (150–940) | 680 (1–6374) | 0.075 |
Blood transfusion, n (%) | 3 (27.3%) | 63 (28.6%) | 0.807 |
Complication (grade ≥ 3*), n (%) | 3 (27.3%) | 62 (28.2%) | 0.781 |
In-hospital death, n (%) | 0 (0%) | 9 (4.1%) | 0.494 |
Pathological findings | |||
Histology well / mod / poor / other, n | 3/7/1/0 | 80/100/23/17 | 0.521 |
T3 or T4, n | 9 (81.8%) | 80 (36.4%) | 0.003 |
Lymph node metastasis, n (%) | 8 (72.7%) | 90 (40.9%) | 0.037 |
Number of metastatic LN (median, range) | 2 (0–28) | 0 (0–11) | 0.018 |
M1, n (%) PALN Lymph node* Liver | 3 (27.3%) 3 (27.3%) 0 (0%) 0 (0%) | 18 (8.2%) 15 (6.8%) 2 (0.9%) 1 (0.5%) | 0.107 0.058 0.751 0.823 |
Residual tumor, n (%) | |||
R0 R1 R2 | 4 (36.4%) 7 (63.6%) 0 (0%) | 161 (73.2%) 57 (25.9%) 2 (0.9%) | 0.021 |
Positive PWC (n = 11) | Negative PWC (n = 220) | P value | |
---|---|---|---|
Adjuvant chemotherapy, n (%) | 10 (90.9%) | 156 (70.9%) | 0.273 |
Recurrence, n (%) | 9 (81.8%) | 97 (44.1%) | 0.014 |
Initial recurrence site, n (%) | |||
Peritoneum Local Liver Lung Lymph node Others | 6 (54.5%) 1 (9.1%) 2 (18.2%) 0 (0%) 1 (9.1%) 1 (9.1%) | 20 (9.1%) 32 (14.5%) 31 (14.1%) 14 (6.4%) 25 (11.4%) 9 (4.1%) | 0.017 0.950 0.950 0.829 0.798 0.513 |
Survival after recurrence (months) (median) | 9.6 | 10.7 | 0.231 |
Case | Disease | Age | Sex | CA19-9 | UICC Stage | Adjuvant chemotherapy | Initial Recurrence | Time interval to recurrence* | Survival Period* | Outcome |
---|---|---|---|---|---|---|---|---|---|---|
1 | ICC | 46 | F | 4207 | T2N2M1* Stage 4 | GS | Local | 11 m | 16 m | D (BTC) |
2 | ICC | 71 | F | 506 | T4N0M0 Stage 3 | GS | Bone | 7 m | 10 m | D (BTC) |
3 | ICC | 51 | F | 18 | T3N1M1* Stage 4 | GS | Liver | 24 m | 37 m | D (BTC) |
4 | HC | 70 | M | 734 | T3N0M0 Stage 3 | GS | Peritoneum | 14 m | 31 m | D (BTC) |
5 | HC | 71 | M | 470 | T3N1M0 Stage 3 | GS | Peritoneum | 29 m | 49 m | A (Recurrence) |
6 | HC | 74 | F | 3489 | T3N1M0 Stage 3 | None | Peritoneum, LN | 3 m | 4 m | D (BTC) |
7 | HC | 77 | F | 92 | T3N1M0 Stage 3 | GS | None | None | 8 m | D (other) |
8 | GBC | 74 | F | 764 | T3N1M1* Stage 4 | GS | Peritoneum, Liver | 3 m | 11 m | D (BTC) |
9 | GBC | 85 | M | 186 | T3N0M0 Stage 3 | S1 | Peritoneum | 6 m | 23 m | D (BTC) |
10 | DC | 68 | M | 81 | T3N2M0 Stage 3 | GS | Peritoneum | 5 m | 16 m | D (BTC) |
11 | DC | 78 | F | 4 | T2N1M0 Stage 2 | GS | None | None | 141 m | A (RFS) |
Factors | Odds ratio* | P value |
---|---|---|
CA19-9 (> 80 U/mL) | 5.84 (1.17 – 29.0) | 0.031 |
T3 or T4 | 4.35 (0.87–22.0) | 0.074 |
Number of lymph node metastasis (≥ 2) | 5.28 (1.28 – 21.8) | 0.021 |