The postoperative peak number of leukocytes after hepatectomy is a significant prognostic factor for cholangiocarcinoma

Abstract

Cholangiocarcinoma (CCA) is a lethal disease. A new predictive factor to identify patients suitable for adjuvant chemotherapy is needed. The relationship between the long-term prognosis and the perioperative immune responses in patients with CCA remains unclear. We therefore investigated the clinical impact of perioperative immune responses on the long-term prognosis in patients receiving hepatectomy for CCA. We investigated 81 patients who underwent hepatectomy between February 2000 and October 2012: 57 intra-hepatic CCA (iCCA) patients and 24 extra-hepatic CCA (eCCA) patients. We checked the postoperative level of C-reactive protein and the numbers of leukocytes. A multivariate analysis of the clinicopathological factors identified 2 significant risk factors for the overall survival: The postoperative maximum number of leukocytes (PNL) among patient factors (P=0.0406) and the TNM-stage among tumor factors (P=0.0059). On evaluating the distribution of each kind of leukocyte with a multivariate analysis, both the postoperative maximum number of neutrophils (PNN) and the postoperative maximum number of eosinophils (PNE) were detected as significant factors among leukocytes (PNN/PNE, P= 0.0367/0.0083). In conclusion, the PNL after hepatectomy was significantly associated with the long-term prognosis in patients with CCA. Changes in the numbers of leukocytes after hepatectomy may be a marker on treatment for CCA.

Preoperative leukocytosis and the resection severity index are independent risk factors for survival in patients with intrahepatic cholangiocarcinoma

“…Several studies have emphasized the prognostic value of inflammatory parameters and indices, such as elevated serum C-reactive protein levels or elevated neutrophil to lymphocyte ratios on postoperative survival in patients undergoing surgery for ICC [22][23][24][25][26][27]. To our knowledge, our study is the first to identify preoperative leukocytosis as an independent risk factor for survival.…”

Development of the RF-GSEA Method for Identifying Disulfidptosis-Related Genes and Application in Hepatocellular Carcinoma

“…Abundant infiltration of CD56 bright natural killer cells is indicative of a better prognosis in HCC and is positively correlated with the apoptosis of tumor cells in HCC [37]. Furthermore, previous research has also indicated a positive correlation between eosinophils and the prognosis of HCC [38,39]. In contrast, the high-DR score group exhibited higher levels of infiltration of activated CD4 T cells, activated dendritic cells, central memory CD4 T cells, effector memory CD4 T cells, regulatory T cells, and type 2 T helper cells compared to the low-DR score group.…”

Assessment of Tumor-Associated Tissue Eosinophilia (TATE) and Tumor-Associated Macrophages (TAMs) in Canine Transitional Cell Carcinoma of the Urinary Bladder

“…Considering human tumors, the involvement of eosinophils in cancer progression has also been suggested, highlighting the potential of these cells as prognostic markers [48,50,51]. The positive influence of eosinophils on prognosis has been evidenced not only in bladder cancer but also in other tumors, such as melanoma [30,[52][53][54] and breast, ovarian [55], cervical [12], bladder [52], liver [56], gastric [57], esophageal [58], and colorectal tumors [59]. In a study on esophageal squamous cell carcinoma, eosinophils were associated with protection against cancer through the release of reactive oxygen species and the suppression of IL-17 [60].…”