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Prognostic impact of pre- and postoperative tumor markers in patients with intrahepatic cholangiocarcinoma

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Abstract

Purpose

The present study assessed the impact of pre- and postoperative tumor markers on the survival of patients with intrahepatic cholangiocarcinoma.

Methods

Medical records of 73 patients with intrahepatic cholangiocarcinoma were reviewed retrospectively. The pre- and postoperative carcinoembryonic antigen and carbohydrate antigen 19-9 levels were assessed. Patient characteristics, clinicopathological factors, and prognostic factors were analyzed.

Results

The median recurrence-free survival and overall survival were 30.0 and 90.9 months, respectively. A multivariate survival analysis revealed that elevated postoperative carbohydrate antigen 19-9 (p = 0.023) was the only independent poor prognostic factor. The median overall survival of patients with normal and elevated postoperative carbohydrate antigen 19-9 levels was 101.4 and 15.7 months (p < 0.001), respectively. Multivariate logistic regression identified elevated preoperative carbohydrate antigen 19-9 as an independent preoperative risk factor for elevated postoperative carbohydrate antigen 19-9. The optimal cutoff value of preoperative carbohydrate antigen 19-9 for predicting elevated postoperative carbohydrate antigen 19-9 was 40 U/mL, with a sensitivity and specificity of 92% and 87%, respectively (area under curve = 0.915).

Conclusions

Elevated postoperative carbohydrate antigen 19-9 was an independent poor prognostic factor. Preoperative predictors, such as elevated preoperative carbohydrate antigen 19-9, may indicate the need for neoadjuvant therapies to improve the survival.

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Abbreviations

ICC:

Intrahepatic cholangiocarcinoma

CEA:

Carcinoembryonic antigen

CA 19–9:

Carbohydrate antigen 19–9

OS:

Overall survival

HR:

Hazard ratio

CI:

Confidence interval

OR:

Odds ratio

IQR:

Interquartile range

RFS:

Recurrence-free survival

ROC:

Receiver operating characteristic curve

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Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Author information

Authors and Affiliations

  1. Department of Gastroenterological Surgery, Division of Gastroenterology, Hiroshima University Hospital, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan

    Kenjiro Okada, Tsuyoshi Kobayashi, Shintaro Kuroda, Hiroaki Mashima, Masakazu Hashimoto, Hiroyuki Tahara, Masahiro Ohira, Kenichiro Uemura & Hideki Ohdan

  2. Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan

    Kenjiro Okada, Kenichiro Uemura & Shinya Takahashi

  3. Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-Ku, Hiroshima, 734-8551, Japan

    Tsuyoshi Kobayashi, Shintaro Kuroda, Hiroaki Mashima, Masakazu Hashimoto, Hiroyuki Tahara, Masahiro Ohira & Hideki Ohdan

Authors
  1. Kenjiro Okada
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  2. Tsuyoshi Kobayashi
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  3. Shintaro Kuroda
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  4. Hiroaki Mashima
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  7. Masahiro Ohira
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  8. Kenichiro Uemura
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  9. Shinya Takahashi
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  10. Hideki Ohdan
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Contributions

Okada designed the study and wrote the initial draft of the article. Kobayashi and Ohdan contributed to interpretation of the data and critical revision of the article for important intellectual content. All other authors (KS, MH, HM, TH, OM, UK, and TS) contributed to data collection and interpretation and critically reviewed the article. All of the authors have read and approved the final version of the article and have agreed to be accountable for all aspects of the study, ensuring that any questions related to the accuracy or integrity of any part of the work are resolved.

Corresponding author

Correspondence to Tsuyoshi Kobayashi.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The protocol for this research project was approved by a suitably constituted Ethics Committee of the institution, and it conforms to the provisions of the Declaration of Helsinki. Committee of institutional review board of Hiroshima University, Approval No. E-778.

Consent to participate

All patients provided their signed informed consent before surgery.1

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Okada, K., Kobayashi, T., Kuroda, S. et al. Prognostic impact of pre- and postoperative tumor markers in patients with intrahepatic cholangiocarcinoma. Surg Today 54, 177–185 (2024). https://doi.org/10.1007/s00595-023-02715-8

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  • DOI: https://doi.org/10.1007/s00595-023-02715-8

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