Colangiocarcinoma hiliar: el número de ganglios positivos y la relación ganglios positivos/ganglios totales son un factor pronóstico importante de supervivencia

Intrahepatic cholangiocarcinoma prognostic determination using pre-operative serum C-reactive protein levels

“…Several prognostic factors have been identified for the prediction of IHCC patient survival. These factors include staging [ 10 ], para-aortic lymph node status [ 11 ], positive node to the total node ratio [ 12 ], tumor size, and the presence of multiple tumors [ 13 ]. Other novel molecular biomarkers, such as hepatoma-derived growth factor [ 14 ], SOX4 [ 15 ], loss of FBXW7 expression [ 16 ], Homer1 [ 17 ], and inactivation of Smad4 [ 18 ], seem to be associated with poor IHCC patient prognosis.…”

The clinicopathological factors associated with prognosis of patients with resectable perihilar cholangiocarcinoma

“…A total of 38 observational studies, studying the prognostic survival factors, including 2 prospective cohorts [ 31 , 37 ] and 36 retrospective cohort studies [ 2 – 17 , 20 – 30 , 38 – 46 ] met the inclusion criteria. Of those publications, 29 studies [ 3 – 7 , 9 , 12 , 13 , 15 – 17 , 20 , 21 , 23 – 26 , 28 , 30 , 31 , 37 – 41 ] used OS as endpoint alone, 5 studies [ 8 , 10 , 11 , 22 , 29 ] used both OS and disease-free survival (DFS), 3 studies [ 2 , 27 , 42 ] used disease-specific survival (DSS), and only 1 study [ 14 ] reported both OS and DSS. In addition, 21 studies (55%) were carried out in Eastern countries, [ 3 – 5 , 9 , 12 , 16 , 17 , 20 , 21 , 23 – 25 , 27 – 31 , 39 , 40 , 44 , 45 ] 16 studies (42%) were performed in Western countries, [ 6 – 8 , 10 , 11 , 13 – 15 , 22 , 26 , 37 , 38 , 41 – 43 , …”

“…The prognostic value of quantitative analysis of clinicopathological parameters were performed, which including the positive surgical resection margins, lymph node involvement, histological grade, operative transfusion, and T-stage (T3/T4) based on American Joint Committee on Cancer 6th/7th edition, and the male gender. Moreover, as mentioned only by the following groups, the age of resectable pCCA (≥70 or ≥69), [ 12 , 14 ] caudate lobe invasion, [ 10 ] papillary tumor, [ 42 ] adjuvant chemotherapy, [ 10 ] symptomatic at presentation, [ 29 ] history of hepatitis, [ 43 ] transmural extension of gall bladder, [ 25 ] surgical margins of bile duct <5 mm, [ 12 ] the preoperative serum total bilirubin (>3.0 mg/dL) and CA19–9 level (>196 U/L), [ 5 , 28 , 30 ] no hepatic resection, [ 7 ] portal vein and/or hepatic artery resection, [ 24 , 27 , 40 ] PTBD, [ 12 , 16 ] and the ratio of lymph nodes involved to lymph nodes retrieved [ 13 , 26 , 38 ] (>0.2 or >0.25) were reported as the risk factor of prognosis in resectable pCCA as well. However, it can thus be conceivably hypothesized that pooled analysis would be conducted to determine the correlation between these clinical parameters and the prognosis of resectable pCCA patients once the sample size increases.…”

“…Besides 6 clinicopathological factors associated with the survival of resectable pCCA as described above, allowing a pooled analysis, there were more than 10 clinicopathological factors, such as the age of patients (≥70 or ≥69), caudate lobe invasion, papilliary tumor, adjuvant chemotherapy, symptomatic at presentation, history of hepatitis, transmural extension of gall bladder, surgical margins of bile duct <5 mm, the preoperative serum total bilirubin (>3.0 mg/dL) and CA19–9 level (>196 U/L), no-hepatic resection, portal vein and/ or hepatic artery resection, PTBD, and the ratio of lymph nodes involved to lymph nodes retrieved (>0.2 or >0.25), were demonstrated as poor prognostic factors of resectable pCCA by many published studies. [ 5 , 12 – 14 , 16 , 26 – 28 , 30 , 38 , 42 ] Nevertheless, due to the limitation of sample size, the quantitative analysis was not able to be performed, but we should be cautious in interpreting those results since there may have some overlap or some unclear risk bias in terms of the significant result, for example, although 2 retrospective studies reported by Komaya et al [ 16 ] and Hirano et al [ 12 ] found that PTBD was associated with a reduced OS in resectable pCCA, but there was apparently some overlap in dividing participation into PTBD group and EBD group: 62 out of 168 (37%) patients from Komaya cohort and 10 out of 67 (15%) patients from Hirano cohort in PTBD groups had undergone EBD prior to undergoing PTBD, but for data analysis, those patients with a history of EBD prior to PTBD were included in PTBD group versus subjects with EBD alone palliating jaundice successfully.…”

“…Assessment of risk of bias for each study included in this meta-analysis showed that 19 studies with an unclear risk, [ 2 – 7 , 24 , 26 , 28 , 31 , 37 – 43 ] 15 with a low risk, [ 8 , 9 , 12 , 16 , 17 , 20 – 23 , 25 , 27 , 29 , 30 , 44 , 46 ] and 4 with a high risk of bias, [ 10 , 14 , 15 , 45 ] as depicted in Supplementary Table 4. Begg funnel plots of the results of surgical resection margins (Fig.…”