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Preoperative Cholangitis and Metastatic Lymph Node Have a Negative Impact on Survival After Resection of Extrahepatic Bile Duct Cancer

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Abstract

Background

The significance of the presence of preoperative inflammation for the prognosis of patients with extrahepatic bile duct cancer (BDCA) was evaluated.

Methods

The clinical data of 84 patients who underwent surgery for BDCA from August 2003 to May 2009 were reviewed, and survival analysis was performed. The patients were classified into two groups according to the presence of preoperative cholangitis: Group A had no cholangitis (n = 59), and group B had cholangitis (n = 25).

Results

There were no differences in sex, mean age, TNM stage, biliary drainage, type of resection, or radicality between the two groups (p > 0.05). The 3-year disease-specific survival (DSS) and disease-free survival (DFS) rates for the group B patients (21.5 and 11.9 %, respectively) were significantly lower than those for the group A patients (66.1 and 57.3 %, respectively; p = 0.013 and 0.001, respectively). The multivariate analysis showed that preoperative inflammation and lymph node metastasis were the independent prognostic factors for both overall survival (OS) [p = 0.021, relative risk (RR) = 2.224 and p = 0.015, RR = 2.367, respectively] and DFS (p = 0.014; RR = 2.192 and p = 0.013; RR = 2.240, respectively). The rates of angiolymphatic and perineural invasion were higher for group B than those for group A (p = 0.016 and 0.030, respectively).

Conclusions

The presence of preoperative inflammation is an independent poor prognostic factor for OS and DFS for patients with BDCA.

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References

  1. Coussens LM, Werb Z (2002) Inflammation and cancer. Nature 420:860–867

    Article  PubMed  CAS  Google Scholar 

  2. Crozier JE, McKee RF, McArdle CS et al (2007) Preoperative but not postoperative systemic inflammatory response correlates with survival in colorectal cancer. Br J Surg 94:1028–1032

    Article  PubMed  CAS  Google Scholar 

  3. Han HS, Cho JY, Yoon YS et al (2011) Preoperative inflammation is a prognostic factor for gallbladder carcinoma. Br J Surg 98:111–116

    Article  PubMed  Google Scholar 

  4. Nakeeb A, Pitt HA, Sohn TA et al (1996) Cholangiocarcinoma: a spectrum of intrahepatic, perihilar, and distal tumors. Ann Surg 224:463–473 discussion 473–465

    Article  PubMed  CAS  Google Scholar 

  5. Wada K, Takada T, Kawarada Y et al (2007) Diagnostic criteria and severity assessment of acute cholangitis: Tokyo guidelines. J Hepatobiliary Pancreat Surg 14:52–58

    Article  PubMed  Google Scholar 

  6. Jamieson GG, Thompson SK (2009) Detection of lymph node metastases in oesophageal cancer. Br J Surg 96:21–25

    Article  PubMed  CAS  Google Scholar 

  7. Murri AM, Hilmy M, Bell J et al (2008) The relationship between the systemic inflammatory response, tumour proliferative activity, T-lymphocytic and macrophage infiltration, microvessel density and survival in patients with primary operable breast cancer. Br J Cancer 99:1013–1019

    Article  PubMed  CAS  Google Scholar 

  8. Balkwill F, Mantovani A (2001) Inflammation and cancer: back to virchow? Lancet 357:539–545

    Article  PubMed  CAS  Google Scholar 

  9. Tingstedt B, Johansson P, Andersson B et al (2007) Predictive factors in pancreatic ductal adenocarcinoma: role of the inflammatory response. Scand J Gastroenterol 42:754–759

    Article  PubMed  CAS  Google Scholar 

  10. McMillan DC, Canna K, McArdle CS (2003) Systemic inflammatory response predicts survival following curative resection of colorectal cancer. Br J Surg 90:215–219

    Article  PubMed  CAS  Google Scholar 

  11. Roxburgh CS, Salmond JM, Horgan PG et al (2009) Comparison of the prognostic value of inflammation-based pathologic and biochemical criteria in patients undergoing potentially curative resection for colorectal cancer. Ann Surg 249:788–793

    Article  PubMed  Google Scholar 

  12. Pine JK, Fusai KG, Young R et al (2009) Serum C-reactive protein concentration and the prognosis of ductal adenocarcinoma of the head of pancreas. Eur J Surg Oncol 35:605–610

    Article  PubMed  CAS  Google Scholar 

  13. Halazun KJ, Aldoori A, Malik HZ et al (2008) Elevated preoperative neutrophil to lymphocyte ratio predicts survival following hepatic resection for colorectal liver metastases. Eur J Surg Oncol 34:55–60

    Article  PubMed  CAS  Google Scholar 

  14. Kanai M, Nimura Y, Kamiya J et al (1996) Preoperative intrahepatic segmental cholangitis in patients with advanced carcinoma involving the hepatic hilus. Surgery 119:498–504

    Article  PubMed  CAS  Google Scholar 

  15. Hassan MO, Maksem J (1980) The prostatic perineural space and its relation to tumor spread: an ultrastructural study. Am J Surg Pathol 4:143–148

    Article  PubMed  CAS  Google Scholar 

  16. Bhuiya MR, Nimura Y, Kamiya J et al (1992) Clinicopathologic studies on perineural invasion of bile duct carcinoma. Ann Surg 215:344–349

    Article  PubMed  CAS  Google Scholar 

  17. Bhuiya MR, Nimura Y, Kamiya J et al (1993) Clinicopathologic factors influencing survival of patients with bile duct carcinoma: multivariate statistical analysis. World J Surg 17:653–657. doi:10.1007/BF01659134

    Article  PubMed  CAS  Google Scholar 

  18. Yamaguchi R, Nagino M, Oda K et al (2002) Perineural invasion has a negative impact on survival of patients with gallbladder carcinoma. Br J Surg 89:1130–1136

    Article  PubMed  CAS  Google Scholar 

  19. Shirai K, Ebata T, Oda K et al (2008) Perineural invasion is a prognostic factor in intrahepatic cholangiocarcinoma. World J Surg 32:2395–2402. doi:10.1007/s00268-008-9726-2

    Article  PubMed  Google Scholar 

  20. Allavena P, Garlanda C, Borrello MG et al (2008) Pathways connecting inflammation and cancer. Curr Opin Genet Dev 18:3–10

    Article  PubMed  CAS  Google Scholar 

  21. Halin C, Detmar M (2008) Inflammation, angiogenesis, and lymphangiogenesis. Methods Enzymol 445:1–25

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Ho-Seong Han.

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Cho, J.Y., Han, HS., Yoon, YS. et al. Preoperative Cholangitis and Metastatic Lymph Node Have a Negative Impact on Survival After Resection of Extrahepatic Bile Duct Cancer. World J Surg 36, 1842–1847 (2012). https://doi.org/10.1007/s00268-012-1594-0

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