Clinico-pathological factors and prognosis scale for portal cholangiocarcinoma

Abstract

The objective of this study was to derive a prognostic scale to predict overall survival (OS) after a curative resection of perihilar cholangiocarcinoma (PHC). The data of 55 patients with portal cholangiocarcinoma were analysed. Patients were treated at the A.V. Vishnevsky Institute of Surgery from 2011 to 2015. Surgical treatment after biliary decompression was performed in 37 (67.3%) patients. In the long-term period we observed 36 (97.3%) of the operated patients. The dependence of the OS of clinical and pathological factors of the tumor was analysed using mono- and multifactor regression analysis of Cox proportional hazards models for all operated patients. Total 1-3-, 5-year survival rate was 75.1, 60.5, 37.7, 35% respectively. Significant prognostic factors (monofactorial analysis) include perineural (p=0,05) and vascular invasion (p=0,049), R1 resection (p=0,01), disease stage III or higher (p=0,03), invasion of SI liver (p=0,004), tumor cells differentiation degree (grade) 2 and higher (p=0,0006). Multifactor analysis revealed that the low OS have determined by perineural (p=0,05) and vascular invasion (p=0,008), the degree of differentiation of tumor cells (p=0,001), disease stage (p=0,05), surgical resection margin (p=0.0345). Developed method of predicting OS is a score of prognostic factors. The scale of individual prognosis in patients PHC takes into account both clinical and histopathological tumor characteristics. This scale may be useful to optimize the individual treatment.