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Preoperative biliary drainage-related inflammation is associated with shorter survival in biliary tract cancer patients

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Abstract

Background

An association between inflammation and patient prognosis has been reported in various types of cancer. The aim of this study was to evaluate the influence of preoperative biliary drainage-related inflammation in patients with biliary tract cancer.

Methods

The clinical data of 97 patients who underwent surgery for extrahepatic bile duct cancer between February 2002 and September 2014 were analyzed, and the prognostic significance of tube-obstructive cholangitis after preoperative biliary drainage and pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) was evaluated.

Results

Eighty-four (86.6 %) of the 97 patients underwent ERCP and preoperative biliary drainage. Tube-obstructive cholangitis occurred in 25 cases and post-ERCP pancreatitis in 8 cases. Collectively, 30 patients experienced preoperative biliary drainage-related inflammation consisting of tube-obstructive cholangitis and/or post-ERCP pancreatitis. Drainage-related inflammation was significant risk factor of postoperative complications (P = 0.006), and significant poor predictors of shorter progression-free survival (P = 0.003) and overall survival (OS; P = 0.006) after surgery. In multivariate analysis, drainage-related inflammation was an independent predictor of shorter OS (hazard ratio, 1.924; P = 0.037) after surgery.

Conclusion

Preoperative biliary drainage-related inflammation was an independent prognostic factor for shorter OS in biliary tract cancer patients.

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Acknowledgments

This study was funded by Grand-in-Aid for Scientific Research (26462067) from the Japan Society for the Promotion of Science, Ministry of Health, Labour and Welfare, Japan.

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Authors and Affiliations

  1. Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan

    Hiroshi Kurahara, Kosei Maemura, Yuko Mataki, Masahiko Sakoda, Satoshi Iino, Yota Kawasaki, Takaaki Arigami, Yoshikazu Uenosono, Yuko Kijima & Shoji Natsugoe

  2. Health Sciences, Kagoshima University, Kagoshima, Japan

    Hiroyuki Shinchi

  3. Frontier Science Research Center, Kagoshima University, Kagoshima, Japan

    Sonshin Takao

Authors
  1. Hiroshi Kurahara
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  2. Kosei Maemura
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  3. Yuko Mataki
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  4. Masahiko Sakoda
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  5. Satoshi Iino
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  8. Yoshikazu Uenosono
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  9. Yuko Kijima
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  10. Hiroyuki Shinchi
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  11. Sonshin Takao
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  12. Shoji Natsugoe
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Corresponding author

Correspondence to Hiroshi Kurahara.

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The authors declare that they have no conflict of interest.

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Supplementary Figure 1

Kaplan-Meier survival curves of extrahepatic bile duct cancer patients with preoperative biliary drainage according to the presence of preoperative biliary drainage-related inflammation. (A) The median progression-free survival of patients with and without drainage-related inflammation was 15.5 and 33.0 months, respectively (P = 0.005). (B) The median overall survival of patients with and without drainage-related inflammation was 17.0 and 44.5 months, respectively (P = 0.018) (TIFF 2201 kb)

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Kurahara, H., Maemura, K., Mataki, Y. et al. Preoperative biliary drainage-related inflammation is associated with shorter survival in biliary tract cancer patients. Int J Clin Oncol 21, 934–939 (2016). https://doi.org/10.1007/s10147-016-0961-5

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  • DOI: https://doi.org/10.1007/s10147-016-0961-5

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