Abstract
Objective To investigate the appropriate cut-off point of CA19-9level for predicting the prognosis of patients with hilar cholangiocarcinoma(HC)after radical surgery,and to discuss other potential prognostic factors that may affect their prognosis.Methods Totally 168patients who had undergone radical surgery for HC in Eastern Hepatobiliary Surgery Hospital were selected for this study.The relationship of preoperation serum CA19-9level with the clinicopathological characteristics of HC patients was analyzed,and ROC curve was used to determine the appropriate cut-off point of CA19-9 level.The potential factors influencing the prognosis were analyzed by univariate model and the independent factors were analyzed by multivariate methods.Results Preoperative serum CA19-9level was related to pathologic stage,lymph node metastasis,and tumor size in HC patients.The strongest univariate predictor among the categorized preoperative CA19-9 measures was CA19-9level less than 150U/mL(P=0.000).In univariate analysis,the age,tumor size,differentiation degree, Bismuth-Corlette classification,portal vein invasion,hepatic artery invasion,liver invasion,preoperative biliary drainage,lymph node metastasis,and resection margin were identified as significant prognostic factors of HC.Multivariable analysis showed that the differentiation degree,lymph node metastasis,hepatic artery invasion,resection margin and preoperative serum CA19-9level were the independent prognostic factors of HC,with the ORvalues and 95%confidence interval(CI)being 3.359(1.440-7.837),2.973(1. 927-4.587),2.096(1.271-3.455),2.238(1.356-3.694),and 2.954(1.890-4.618),respectively.Conclusion Our results demonstrate that preoperative serum CA19-9level is an independent prognostic factor for HC patients,and the most discriminative cut-off point of CA19-9level for prognosis is 150U/mL.The differentiation degree,lymph node metastasis,hepatic artery invasion, and resection margin are also the independent prognostic factors of HC.
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