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A Novel Biomarker-Based Preoperative Prognostic Grading System for Predicting Survival After Surgery for Intrahepatic Cholangiocarcinoma

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Although treatment strategies for intrahepatic cholangiocarcinoma (ICC) are shifting towards multidisciplinary approaches, preoperative radiographic methods for identifying patients requiring further therapy are unclear. This study was designed to establish a prognostic grading system using preoperatively available objective biomarkers.

Methods

A novel preoperative prognostic grading system for predicting survival after surgery for ICC was developed from multivariate analysis of 134 ICC patients who underwent surgery between 1996 and 2015 using preoperatively available biomarkers.

Results

The median overall survival time and 3- and 5 year survival rates were 33.3 months, 48, and 38%, respectively. Of the preoperative biomarkers, the neutrophil-to-lymphocyte ratio (≥5), and C-reactive protein (≥5 mg/L) and carbohydrate antigen 19-9 (≥500 IU/mL) levels were independently associated with poor overall survival. Based on the presence of these factors, the preoperative prognostic grades were defined as follows: grade 1, no factor; grade 2, one factor; and grade 3, two or three factors. The median overall survival time and 3- and 5 year survival rates of patients with grade 1 (70.3 months, 66, and 53%, respectively) were higher than those of patients with grade 2 (23.4 months, 37, and 30%, respectively; P = 0.004) and grade 3 (8.8 months, 5% both; 2 vs. 3, P < 0.001). Multivariable analysis revealed that the preoperative prognostic grading system independently predicted survival after adjusting for known prognostic factors.

Conclusions

A novel biomarker-based preoperative prognostic grading system for ICC significantly stratifies survival after surgery and may identify patients requiring further treatment.

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Authors and Affiliations

  1. Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Tomoaki Yoh MD, Satoru Seo MD, PhD, Kojiro Taura MD, PhD, Hiroaki Fuji MD, Yoshinobu Ikeno MD, Yukihiro Okuda MD, Kentaro Yasuchika MD, PhD, Toshimi Kaido MD, PhD, Hideaki Okajima MD, PhD & Shinji Uemoto MD, PhD

  2. Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan

    Etsuro Hatano MD, PhD

Authors
  1. Tomoaki Yoh MD
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  2. Satoru Seo MD, PhD
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  3. Etsuro Hatano MD, PhD
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  4. Kojiro Taura MD, PhD
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  5. Hiroaki Fuji MD
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  6. Yoshinobu Ikeno MD
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Correspondence to Satoru Seo MD, PhD.

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The authors declare no conflict of interest.

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Yoh, T., Seo, S., Hatano, E. et al. A Novel Biomarker-Based Preoperative Prognostic Grading System for Predicting Survival After Surgery for Intrahepatic Cholangiocarcinoma. Ann Surg Oncol 24, 1351–1357 (2017). https://doi.org/10.1245/s10434-016-5708-z

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