Does the extent of lymphadenectomy, number of lymph nodes, positive lymph node ratio and neutrophil–lymphocyte ratio impact surgical outcome of perihilar cholangiocarcinoma?

Hakeem, Abdul; Marangoni, Gabriele; Chapman, Stephen J.; Young, Richard S.; Nair, Amit; Hidalgo, Ernest; Toogood, Giles J.; Wyatt, Judy; Lodge, Peter; Prasad, K. Raj

doi:10.1097/meg.0000000000000162

Cited by 49 publications

(52 citation statements)

References 35 publications

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“…Only one of the previous report identified NLR as an independent prognostic factor for disease-free survival 34 . However, these two reports showed that NLR was not an independent prognostic factor in survival 34,42 . As far as we know, this report is the first to show that PLR was a significant prognostic factor for survival.…”

Section: Discussionmentioning

confidence: 98%

“…To the best of our knowledge, only two previous reports evaluated NLR in perihilar cholangiocarcinoma 34,42 . Only one of the previous report identified NLR as an independent prognostic factor for disease-free survival 34 .…”

Section: Discussionmentioning

confidence: 99%

“…The gastrointestinal cancers also associated with SIR: intrahepatic cholangiocarcinoma, colorectal cancer, liver metastases of colon cancer origin, and hepatocellular cancer 19,20,[24][25][26]41 . However, only a few reports were available on perihilar cholangiocarcinoma 34,42 .…”

Section: Discussionmentioning

confidence: 99%

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A new prognostic scoring system using factors available preoperatively to predict survival after operative resection of perihilar cholangiocarcinoma

Saito

Noji

Okamura

et al. 2016

Surgery

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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A new prognostic scoring system using factors available preoperatively to predict survival after operative resection of perihilar cholangiocarcinoma

Saito

Noji

Okamura

et al. 2016

Surgery

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“…In addition, several studies demonstrated a significant correlation between GPS/modified GPS and the survival of patients with extrahepatic bile duct cancer following surgical resection [12, 13]. However, controversies still exist regarding the prognostic value of NLR in cholangiocarcinoma [8-12, 26]. Likewise, conflicting survival data are present regarding PLR in cholangiocarcinoma patients [10, 12, 26, 27].…”

Section: Discussionmentioning

confidence: 99%

“…Neutrophil counts, lymphocyte counts, platelet counts, elevated C-reactive protein (CRP) levels, and hypoalbuminemia have been converted to ratios or scores, such as the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), and Glasgow Prognostic Score (GPS) [6], which have frequently been associated with the prognosis of solid tumors [5-7]. However, there are conflicting survival data regarding preoperative hematological inflammatory parameters in cholangiocarcinoma [8-14]. …”

Section: Introductionmentioning

confidence: 99%

Association of Preoperative Platelet-to-Lymphocyte Ratio with Poor Outcome in Patients with Distal Cholangiocarcinoma

et al. 2019

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Background: Several preoperative systemic inflammatory parameters, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and Glasgow Prognostic Score, have been reported to be associated with the prognosis of solid tumors. However, there are conflicting survival data regarding these parameters in cholangiocarcinoma. Objectives: In this study, we performed a retrospective cohort analysis of patients with distal cholangiocarcinoma (DCC) who underwent surgical resection to evaluate the prognostic value of a cluster of preoperative hematological inflammatory parameters for survival. Method: Fifty-three patients with DCC who underwent pancreaticoduodenectomy with curative intent were enrolled. The optimal cutoff values of hematological inflammatory parameters, including the absolute lymphocyte count, NLR, PLR, and LMR, were determined by time-dependent receiver operating characteristic analysis. Results: The univariate analysis for overall survival (OS) of conventional factors and hematological inflammatory parameters identified that portal vein invasion and PLR had p values of ≤0.1. The univariate analysis for disease-free survival (DFS) identified that lymph node metastasis, PLR, lymphocyte count, and number of positive lymph nodes (≥3) had p values of ≤0.1. These factors were incorporated into the full model and variables were selected using the backward stepwise method. The multivariate analysis identified portal vein invasion and high PLR as independent prognostic factors for OS (p = 0.033 and 0.039, respectively) and high PLR and number of positive lymph nodes (≥3) as independent prognostic factors for DFS (p = 0.016 and 0.004, respectively). Conclusions: Preoperative PLR assessment may be useful for detecting high-risk DCC patients undergoing surgical resection for aggressive adjuvant therapy.

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Association of Lymph Node Status With Survival in Patients After Liver Resection for Hilar Cholangiocarcinoma in an Italian Multicenter Analysis

et al. 2016

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Does the extent of lymphadenectomy, number of lymph nodes, positive lymph node ratio and neutrophil–lymphocyte ratio impact surgical outcome of perihilar cholangiocarcinoma?

Abstract: Extended lymphadenectomy patients (≥20 LNs) had worse OS when compared with those with more limited (<20 LNs) resection. An LNR of at least 0.37 is an independent predictor of DFS.

Cited by 49 publications

References 35 publications

A new prognostic scoring system using factors available preoperatively to predict survival after operative resection of perihilar cholangiocarcinoma

A new prognostic scoring system using factors available preoperatively to predict survival after operative resection of perihilar cholangiocarcinoma

Association of Preoperative Platelet-to-Lymphocyte Ratio with Poor Outcome in Patients with Distal Cholangiocarcinoma

Association of Lymph Node Status With Survival in Patients After Liver Resection for Hilar Cholangiocarcinoma in an Italian Multicenter Analysis

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