Analysis Of The Prognostic Factors Of Hilar Cholangiocarcinoma After Radical Resection

Aims:Hilar cholangiocarcinoma is a malignant neoplasm with poor prognosis. The aim of this study was to investigate the prognostic factors of hilar cholangiocarcinoma after radical resection.Methods:A total of 78 patients with hilar cholangiocarcinoma after radical resection from January 2010 to December 2014 in the First Affiliated Hospital of Zhejiang University were included retrospectively. Univariate analysis was performed to assess potential prognostic factors including patients’ gender, age, preoperative total bilirubin level, preoperative CA19-9 level, Bismuth-Corlette classification, tumor size, degree of tumor differentiation, lymph node metastasis, portal vein invasion, hepatic artery invasion, liver invasion, surgical methods, portal vein resection and reconstruction, postoperative chemotherapy. Multivariate analysis was performed by COX regression multiple hazard model. Single-factor model was used to explore the prognostic value of the number and ratio of metastatic lymph node in the patients with lymph node metastasis.Results:Univariate analysis showed that the survival of patients with preoperative total bilirubin leve1≥10mg/dl, tumor size≥2.5cm, lymph node metastasis, portal vein invasion, hepatic artery invasion and liver invasion was significantly worse(P< 0.05). Multivariate analysis showed that preoperative total bilirubin level(HR:2.515, P=0.002), portal vein invasion(HR:2.038, P=0.049) and lymph node metastasis(HR:1.873, P=0.031) were independent prognostic factors for the patients with hilar cholangiocarcinoma after radical resection. To the patients with lymph node metastasis, metastatic lymph node ratio≥0.20 was associated with worse prognosis (P=0.048).Conclusion:Preoperative total bilirubin level, tumor size, lymph node metastasis, portal vein invasion, hepatic artery invasion and liver invasion were prognostic factors of hilar cholangiocarcinoma after radical resection. Preoperative total bilirubin level, portal vein invasion and lymph node metastasis were independent factors. To the patients with lymph node metastasis, the most discriminative cutoff of metastatic lymph node ratio for prognosis was 0.20.