Nutritional prognostic scores in patients with hilar cholangiocarcinoma treated by percutaneous transhepatic biliary stenting combined with 125I seed intracavitary irradiation: A retrospective observational study

Medicine (Baltimore). 2018 Jun;97(22):e11000. doi: 10.1097/MD.0000000000011000.

Abstract

We mainly aimed to preliminarily explore the prognostic values of nutrition-based prognostic scores in patients with advanced hilar cholangiocarcinoma (HCCA).We retrospectively analyzed 73 cases of HCCA, who underwent percutaneous transhepatic biliary stenting (PTBS) combined with I seed intracavitary irradiation from November 2012 to April 2017 in our department. The postoperative changes of total bilirubin (TBIL), direct bilirubin (DBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and albumin (ALB) were observed. The preoperative clinical data were collected to calculate the nutrition-based scores, including controlling nutritional status (CONUT), C-reactive protein/albumin ratio (CAR), and prognostic nutritional index (PNI). Kaplan-Meier curve and Cox regression model were used for overall survival (OS) analyses.The serum levels of TBIL, DBIL, ALT, AST, and ALP significantly reduced, and ALB significantly increased at 1 month and 3 months postoperatively. The median survival time of the cohort was 12 months and the 1-year survival rate was 53.1%. Univariate analysis revealed that the statistically significant factors related to OS were CA19-9, TBIL, ALB, CONUT, and PNI. Multivariate analysis further identified CA19-9, CONUT, and PNI as independent prognostic factors.Nutrition-based prognostic scores, CONUT and PNI in particular, can be used as predictors of survival in unresectable HCCA.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Bile Duct Neoplasms / mortality*
  • Bile Duct Neoplasms / radiotherapy
  • Bile Duct Neoplasms / surgery
  • Biliary Tract Surgical Procedures / methods*
  • Cohort Studies
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Iodine Radioisotopes / administration & dosage
  • Klatskin Tumor / mortality*
  • Klatskin Tumor / radiotherapy
  • Klatskin Tumor / surgery
  • Liver Function Tests
  • Male
  • Middle Aged
  • Nutrition Assessment*
  • Nutritional Status
  • Prognosis
  • ROC Curve
  • Retrospective Studies
  • Sensitivity and Specificity
  • Stents / adverse effects
  • Survival Analysis

Substances

  • Iodine Radioisotopes
  • Iodine-125