Portal de Periódicos da CAPES

Survival analysis and prognostic nomogram for patients undergoing resection of extrahepatic cholangiocarcinoma

2012; Elsevier BV; Volume: 23; Issue: 10 Linguagem: Inglês

10.1093/annonc/mds077

1569-8041

Niels A. van der Gaag, Jaap J. Kloek, Jeanette Bakker, Boudewijn Musters, Ronald B. Geskus, Olivier R. Busch, A. Bosma, Dirk J. Gouma, Thomas M. van Gulik,

Pancreatic and Hepatic Oncology Research

BackgroundTumor location of extrahepatic cholangiocarcinoma (CCA) might influence survival after resection.MethodsA consecutive series of 175 patients who had undergone a potentially curative resection of extrahepatic CCA was analyzed. We calculated concordance indices of different constructed prognostic models for survival including TNM (tumour–node–metastasis) staging and developed a nomogram of the most sensitive model.ResultsOverall cancer-specific survival rates were 83%, 58%, and 26% at 1, 2, and 5 years, respectively. Cancer-specific survival according to location was 42% for proximal, 23% for mid, and 19% for distal CCA after 5 years. Tumor location was not an independent significant predictor (P = 0.06). A prognostic model using all potential prognostic variables predicted survival better compared with TNM staging (concordance index 0.65 versus 0.63). A reduced model containing only lymph node status, microscopically residual tumor status, and tumor differentiation grade, also outperformed TNM staging (concordance index 0.66).ConclusionsTumor location of extrahepatic CCA does not independently predict cancer-specific survival after resection. We developed a nomogram, based on a prognostic model with lymph node status, microscopically residual tumor status of resection margins, and tumor differentiation grade, that predicted survival better than TNM staging.