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Observational Study
. 2020 Sep 3;20(1):849.
doi: 10.1186/s12885-020-07357-4.

Survival analysis of patients with stage T2a and T2b perihilar cholangiocarcinoma treated with radical resection

Jian Zhao  1   2 , Wei Zhang  1   2 , Jun Zhang  1 , Yi Zhang  2 , Wen-Jie Ma  3 , Si-Yun Liu  4 , Fu-Yu Li  3 , Bin Song  5
Affiliations
Observational Study

Survival analysis of patients with stage T2a and T2b perihilar cholangiocarcinoma treated with radical resection

Jian Zhao et al. BMC Cancer. .

Abstract

Background: Both the 7th and 8th editions of the American Joint Committee on Cancer (AJCC) staging system for perihilar cholangiocarcinoma (pCCA) had the same definition for T2a and T2b. But the value of this classification as prognostic factor remains unclear.

Methods: 178 patients with stage T2a or T2b who underwent curative intent resection for pCCA between Jan 2010 and Dec 2018 were enrolled. Relationships between survival and clinicopathological factors including patient demographics and tumor characteristics were evaluated using univariate and multivariate Cox regression analysis. The overall survival (OS) were calculated by Kaplan-Meier method.

Results: There was no significant difference in OS between T2a and T2b groups, and the median OS duration were 37 and 31 months (P = 0.354). Both the 7th and 8th edition of the AJCC TNM staging demonstrated a poor prognostic predictive performance. High level of preoperative AST (≥85.0 IU/L) and CA19-9 (≥1000 U/mL), vascular resection and lower pathological differentiation of the tumor were the independent predictors for poor survival after resection.

Conclusion: The newly released 8th edition of AJCC staging system demonstrated a poor ability to discriminate the prognosis of patients with stage T2a and T2b pCCA after resection.

Keywords: AJCC; Curative intent resection; Overall survival; Perihilar cholangiocarcinoma; Prognosis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan-Meier survival curves of patients underwent surgery for pCCA. a Stratified by AST. b Stratified by CA19–9. c Stratified by vascular resection. (d) Stratified by pathological differentiation
Fig. 2
Fig. 2
Kaplan-Meier survival curves of patients underwent surgery for pCCA. a Stratified by groupT2a and T2b in total cohort. b Stratified by groupT2a and T2b in N0 subgroup. c Stratified by group T2a and T2b in N1 subgroup. d Stratified by group T2a and T2b in N2 subgroup
Fig. 3
Fig. 3
Kaplan-Meier survival curves of patients underwent surgery for pCCA. a Stratified by the 7th edition of the AJCC N staging. b Stratified by the 8th edition of the AJCC N staging. c Stratified by the 7th edition of the AJCC TNM staging system. d Stratified by the 8th edition of the AJCC TNM staging system. The overall and pairwise log-rank test results between different subgroups’ survival were interpreted as P values at the bottom-left and upper-right corner respectively
See this image and copyright information in PMC

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