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Resected biliary tract cancers: A novel clinical-pathological score correlates with global outcome

By Rossana Berardi, Federico Mocchegiani, Chiara Pierantoni, Alen Federici, Daniele Nicolini, Francesca Morgese, Azzurra Onofri, Andrea Risaliti, Marco Vivarelli and Stefano Cascinu


BACKGROUND: Biliary tract cancer presents a poor prognosis. AIMS: The objective of this study is to find clinical-laboratory parameters like prognostic factors to select patients who can benefit from surgery and post-operative treatments. METHODS: Between 2005 and 2010, 41 patients underwent radical surgery at our Institution. A novel score was retrospectively calculated assigning a grade to the clinical-laboratory findings at diagnosis. 0 and 1 point were respectively assigned to the normal or abnormal parameter. Two groups were identified: SCORE 0 and SCORE 1. RESULTS: Patients with cholangiocarcinoma or Klatskin tumours or asymptomatic at diagnosis presented a significantly better overall survival (OS) than patients with different primary sites or who presented pain, jaundice or cholangitis. At univariate analysis, high levels of aspartate aminotransferase, alanine aminotransferase and CA19-9 before surgery, hyperbilirubinemia before and after surgery had a negative correlation with OS. A worse OS was observed in patients with a higher score (median OS in the "score 0" group=30.79 months vs. median OS in the "score 1"=17.98 months). CONCLUSION: Our results suggest that pre and post-surgery clinical-laboratory parameters and the novel score, could be useful, especially for intrahepatic tumours, in predicting the outcome in patients undergoing surgery and in selecting patients to receive adjuvant therapy

Topics: Biliary tract cancer, Clinical-pathological score, Prognostic factor, Radical surgery, Aged, Aged, 80 and over, Alanine Transaminase, Antigens, Tumor-Associated, Carbohydrate, Aspartate Aminotransferases, Biliary Tract Neoplasms, Cholangiocarcinoma, Female, Gallbladder Neoplasms, Humans, Hyperbilirubinemia, Klatskin Tumor, Male, Middle Aged, Preoperative Period, Prognosis, Retrospective Studies, Treatment Outcome, Severity of Illness Index, Gastroenterology, Hepatology
Publisher: 'Elsevier BV'
Year: 2013
DOI identifier: 10.1016/j.dld.2012.08.012
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