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Risk stratification and prognostic nomogram for post-recurrence overall survival in patients with recurrent extrahepatic cholangiocarcinoma

Title
Risk stratification and prognostic nomogram for post-recurrence overall survival in patients with recurrent extrahepatic cholangiocarcinoma
Authors
Kim B.H.Kim K.Chie E.K.Kwon J.Jang J.-Y.Kim S.W.Oh D.-Y.Bang Y.-J.
Ewha Authors
김규보
SCOPUS Author ID
김규보scopus
Issue Date
2017
Journal Title
HPB
ISSN
1365-182XJCR Link
Citation
vol. 19, no. 5, pp. 421 - 428
Publisher
Elsevier B.V.
Indexed
SCIE; SCOPUS WOS scopus
Abstract
Background This study aimed to investigate post-recurrence overall survival (PROS) in patients with recurrent extrahepatic cholangiocarcinoma (EHC) and to indicate which groups of patients need active salvage treatments. Methods We retrospectively reviewed the records of 251 consecutive patients who underwent curative surgery followed by adjuvant chemoradiotherapy for EHC. Among these, 144 patients experienced a recurrence and were included for further analysis. Results The median PROS was 7 months (range, 1–130). In multivariate analysis, poorly differentiated histology, short disease-free survival, poor performance status, and elevated CA 19-9 were identified as significant prognosticators for poor PROS. Based on this, we stratified study patients into three categories by the number of risk factors: group 1 (0 or 1 factors), group 2 (2 factors) and group 3 (3–4 factors). Median PROS for groups 1, 2, and 3 were 13, 7, and 5 months, respectively (p < 0.001). Group 1 patients showed a significant benefit from salvage treatment, but groups 2 and 3 did not demonstrate clear benefit. In addition, we developed a nomogram to specifically identify individual patient's prognosis. Conclusion Our simple risk stratification as well as proposed nomogram can classify patients into subgroups with different prognosis and will help facilitate personalized strategies after recurrence. © 2017 International Hepato-Pancreato-Biliary Association Inc.
DOI
10.1016/j.hpb.2016.12.014
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의학전문대학원 > 의학과 > Journal papers
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