Resected biliary tract cancers: a novel clinical-pathological score correlates with global outcome

Dig Liver Dis. 2013 Jan;45(1):70-4. doi: 10.1016/j.dld.2012.08.012. Epub 2012 Sep 19.

Abstract

Background: Biliary tract cancer presents a poor prognosis.

Aims: The objective of this study is to find clinical-laboratory parameters like prognostic factors to select patients who can benefit from surgery and post-operative treatments.

Methods: Between 2005 and 2010, 41 patients underwent radical surgery at our Institution. A novel score was retrospectively calculated assigning a grade to the clinical-laboratory findings at diagnosis. 0 and 1 point were respectively assigned to the normal or abnormal parameter. Two groups were identified: SCORE 0 and SCORE 1.

Results: Patients with cholangiocarcinoma or Klatskin tumours or asymptomatic at diagnosis presented a significantly better overall survival (OS) than patients with different primary sites or who presented pain, jaundice or cholangitis. At univariate analysis, high levels of aspartate aminotransferase, alanine aminotransferase and CA19-9 before surgery, hyperbilirubinemia before and after surgery had a negative correlation with OS. A worse OS was observed in patients with a higher score (median OS in the "score 0" group=30.79 months vs. median OS in the "score 1"=17.98 months).

Conclusion: Our results suggest that pre and post-surgery clinical-laboratory parameters and the novel score, could be useful, especially for intrahepatic tumours, in predicting the outcome in patients undergoing surgery and in selecting patients to receive adjuvant therapy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alanine Transaminase / blood
  • Antigens, Tumor-Associated, Carbohydrate / blood
  • Aspartate Aminotransferases / blood
  • Biliary Tract Neoplasms / diagnosis
  • Biliary Tract Neoplasms / physiopathology*
  • Biliary Tract Neoplasms / surgery*
  • Cholangiocarcinoma / diagnosis
  • Cholangiocarcinoma / physiopathology
  • Cholangiocarcinoma / surgery
  • Female
  • Gallbladder Neoplasms / diagnosis
  • Gallbladder Neoplasms / physiopathology
  • Gallbladder Neoplasms / surgery
  • Humans
  • Hyperbilirubinemia
  • Klatskin Tumor / diagnosis
  • Klatskin Tumor / physiopathology
  • Klatskin Tumor / surgery
  • Male
  • Middle Aged
  • Preoperative Period
  • Prognosis
  • Retrospective Studies
  • Severity of Illness Index*
  • Treatment Outcome

Substances

  • Antigens, Tumor-Associated, Carbohydrate
  • carbohydrate antigen 199, human
  • Aspartate Aminotransferases
  • Alanine Transaminase