Prediction of lymph node metastasis and perineural invasion of biliary tract cancer by selected features from cDNA array data1

Abstract Background: The prognostic nutritional index, a marker of nutritional status and systemic inflammation, is a known biomarker for various cancers. However, few studies have evaluated the predictive value of the prognostic nutritional index in patients with biliary tract cancer. Therefore, we investigated the prognostic significance of the prognostic nutritional index and developed a risk-stratification system to identify prognostic factors in patients with biliary tract cancer.Methods: Between July 2010 and March 2021, 117 patients with biliary tract cancer were recruited to this single-center retrospective study. The relationship between clinicopathological variables, including the prognostic nutritional index and overall survival, was analyzed using univariate and multivariate analyses. P < 0.05 was considered statistically significant.Results: The median age was 75 (range, 38–92) years. Thirty patients had intrahepatic cholangiocarcinoma; 29, gallbladder carcinoma; 28, distal cholangiocarcinoma; 16, ampullary carcinoma; and 13, perihilar cholangiocarcinoma. R0 resection was achieved in 99 patients. In univariate analysis, the prognostic nutritional index (< 42), lymph node metastasis, carbohydrate antigen 19-9 level (> 20 U/mL), preoperative cholangitis, tumor differentiation, operation time (≥ 360 minutes), and R1–2 resection were significant risk factors for overall survival. The prognostic nutritional index (P = 0.007), lymph node metastasis (P = 0.024), and tumor differentiation (P = 0.008) were independent prognostic factors in the multivariate analysis. A combined score of the prognostic nutritional index and pathological findings outperformed each marker alone, in terms of discriminatory power.Conclusions: The prognostic nutritional index, lymph node metastasis, and tumor differentiation were independent prognostic predictors after surgical resection in patients with biliary tract cancer. A combined prediction model using the prognostic nutritional index and pathological findings accurately predicted prognosis and can be applied as a novel prognostic indicator for patients with biliary tract cancer.

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Prognostic factor of carcinoma of the ampulla of vater after surgery.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.270 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 270-270 ◽

Cited By ~ 1

Author(s):

Shinjiro Tomiyasu ◽

Eri Oda ◽

Hiroshi Tanaka ◽

Shinji Ishikawa ◽

Hiroki Sugita ◽

...

Keyword(s):

Prognostic Factors ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Biliary Tract ◽

Biliary Tract Cancer ◽

Tnm Stage ◽

Tract Cancer ◽

Node Metastasis ◽

Duodenal Invasion ◽

Pancreatic Invasion

270 Background: General rules for biliary tract cancer in Japan were revised and Stage of biliary tract cancer was compliant with the seventh UICC. Carcinoma of the Ampulla Vater (CAV) is relatively good prognosis among the biliary tract cancer, such as lymph node metastasis, pancreatic invasion and perineural invasion has been reported to be prognostic factors. We investigated the validity of TNM-Stage by examining the prognostic factors from the outcome of resection experienced. Methods: To evaluate prognostic factors after surgery based on a series of 70 patients of CAV from 1996 to 2014. Twenty-eight patients received pancreatoduodenectomy (PD), 25 patients received pylorus-preserving pancreatoduodenectomy (PPPD) and 17 patients received subtotal stomach-preserving pancreatoduodenectomy (SSPPD). We reviewed and analyzed the clinicopathologic data, surgical outcomes, recurrence and survival. Results: Actuarial disease-specific survival (DSS) was 65 % at five years. In univariate analysis, pancreatic invasion, lymph node metastasis and duodenal invasion are significantly poor prognosis. In multivariate analysis, pancreatic invasion is the only poor prognostic factor (p = 0.0023, hazard ratio (HR) 5.31 [confidence interval (CI) 1.77-18.9 95%]); lymph node metastasis and duodenal invasion are not significantly different (p = 0.0672 and 0.8769, respectively). Also, in the study of relapse risk factors, pancreatic invasion and lymph node metastasis are significantly different. In TNM-Stage II, those of T3N0, 1 are poor prognosis than T1, 2N1 (p = 0.0334). Conclusions: Pancreatic invasion is an independent poor prognostic and recurrence risk factor. The Stage of Japanese Society of Biliary Surgery has reflect prognosis than TNM-Stage in carcinoma of the Ampulla Vater.

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A combined prediction model for biliary tract cancer using the prognostic nutritional index and pathological findings: a single-center retrospective study

BMC Gastroenterology ◽

10.1186/s12876-021-01957-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Masashi Utsumi ◽

Koji Kitada ◽

Naoyuki Tokunaga ◽

Takamitsu Kato ◽

Toru Narusaka ◽

...

Keyword(s):

Prognostic Factors ◽

Lymph Node ◽

Biliary Tract ◽

Biliary Tract Cancer ◽

Prognostic Nutritional Index ◽

Tumor Differentiation ◽

Pathological Findings ◽

Tract Cancer ◽

Node Metastasis ◽

Nutritional Index

Abstract Background The prognostic nutritional index, a marker of nutritional status and systemic inflammation, is a known biomarker for various cancers. However, few studies have evaluated the predictive value of the prognostic nutritional index in patients with biliary tract cancer. Therefore, we investigated the prognostic significance of the prognostic nutritional index, and developed a risk-stratification system to identify prognostic factors in patients with biliary tract cancer. Methods Between July 2010 and March 2021, 117 patients with biliary tract cancer were recruited to this single-center, retrospective study. The relationship between clinicopathological variables, including the prognostic nutritional index, and overall survival was analyzed using univariate and multivariate analyses. A P < 0.05 was considered statistically significant. Results The median age was 75 (range 38–92) years. Thirty patients had intrahepatic cholangiocarcinoma; 29, gallbladder carcinoma; 27, distal cholangiocarcinoma; 17, ampullary carcinoma; and 13, perihilar cholangiocarcinoma. Curative (R0) resection was achieved in 99 patients. In univariate analysis, the prognostic nutritional index (< 42), lymph node metastasis, carbohydrate antigen 19-9 level (> 20 U/mL), preoperative cholangitis, tumor differentiation, operation time (≥ 360 min), and R1–2 resection were significant risk factors for overall survival. The prognostic nutritional index (P = 0.027), lymph node metastasis (P = 0.040), and tumor differentiation (P = 0.006) were independent prognostic factors in multivariate analysis. A combined score of the prognostic nutritional index and pathological findings outperformed each marker alone, in terms of discriminatory power. Conclusions The prognostic nutritional index, lymph node metastasis, and tumor differentiation were independent prognostic factors after surgical resection in patients with biliary tract cancer. A combined prediction model using the prognostic nutritional index and pathological findings accurately predicted prognosis, and can be used as a novel prognostic factor in patients with biliary tract cancer.

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Lymph Node Metastasis in the Biliary Tract Carcinoma: CT Evaluation

Journal of the Korean Radiological Society ◽

10.3348/jkrs.1994.31.1.119 ◽

1994 ◽

Vol 31 (1) ◽

pp. 119

Author(s):

Young Soo Do ◽

Byung Hee Lee ◽

Kie Hwan Kim ◽

Soo Yil Chin ◽

Ah Ra Lee

Keyword(s):

Lymph Node ◽

Lymph Node Metastasis ◽

Biliary Tract ◽

Biliary Tract Carcinoma ◽

Node Metastasis ◽

Ct Evaluation

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The prognostic significance of lymph node metastasis and intrapancreatic perineural invasion in pancreatic cancer after curative resection

Surgery Today ◽

10.1007/bf02482964 ◽

1999 ◽

Vol 29 (1) ◽

pp. 16-22 ◽

Cited By ~ 100

Author(s):

Hideo Ozaki ◽

Takehisa Hiraoka ◽

Ryuji Mizumoto ◽

Seiki Matsuno ◽

Yoshiro Matsumoto ◽

...

Keyword(s):

Pancreatic Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Curative Resection ◽

Perineural Invasion ◽

Prognostic Significance ◽

Node Metastasis

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T1 Pancreatic Cancer With Lymph Node Metastasis and Perineural Invasion of the Celiac Trunk

Clinical Gastroenterology and Hepatology ◽

10.1016/j.cgh.2008.07.033 ◽

2008 ◽

Vol 6 (11) ◽

pp. e41-e42 ◽

Cited By ~ 9

Author(s):

Carolin Reiser–Erkan ◽

Jochen Gaa ◽

Jörg Kleeff

Keyword(s):

Pancreatic Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Perineural Invasion ◽

Celiac Trunk ◽

Node Metastasis

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Analysis of clinical and pathological factors in patients undergoing surgery for rectal cancer: a single-centre experience with 692 patients in China

10.21203/rs.3.rs-18628/v1 ◽

2020 ◽

Author(s):

Liping Xu ◽

Chi Zhang ◽

Zhaoyue Zhang ◽

Xinyu Tang ◽

Qin Qin ◽

...

Keyword(s):

Rectal Cancer ◽

Lymph Node ◽

Lymph Node Metastasis ◽

Perineural Invasion ◽

Radical Surgery ◽

Node Metastasis ◽

T Stage ◽

Significant Difference ◽

Tumour Location ◽

Poorly Differentiated

Abstract Background: The management of rectal carcinoma has substantially evolved over the past two decades, so as AJCC staging and NCCN guidelines. The inherent relationships of pathologic factors warrant further study. The present study aimed to assess the associations of clinical and pathological factors in rectal cancer patients undergoing radical surgery.Methods: From October 2015 to February 2019, all rectal cancer patients treated with radical surgery without neoadjuvant therapy were identified. The analysis was performed with data obtained from the prospectively collected database. Predictive factors for lymph node metastasis were analysed.Results: In total, 692 patients with a median age of 61.64 years (range: 22-89) were included. There was no significant difference in onset age between male and female patients (61.75±11.10 vs 61.43±11.92, P=0.723).Tumour location (P=0.004), perineural invasion (PNI) (P=0.000), lymphovascular invasion (LVI) (P=0.000), tumour deposit (TD) (P=0.000), and differentiation grade (P=0.000) were significantly related to pathologic T stage in univariate analysis, while sex was not (p=0.192).Compared to patients with T1 disease, there was a significantly higher proportion of positive LVI in patients with stage T3 disease (P=0.011, OR=3.404, 95% CI: 1.319-8.787) but not in those with T2 (P=0.686, OR=0.804, 95% CI: 0.280-2.310) and T4 (P=0.063, OR=3.200, 95% CI: 0.941-10.886) disease. Compared to patients with T2 disease, there was a significantly higher proportion of perineural invasion in patients with stage T3 (P=0.000, OR=6.2376, 95% CI: 3.371-11.685) but not T4 (P=0.172, OR=2.309, 95% CI: 0.694-7.676) disease. Compared to patients with T1 disease, a significantly higher proportion of TDs occurred in patients with stage T3 (P=0.013, OR=6.106, 95% CI: 1.455-25.631) and stage T4 (P=0.019, OR=7.146, 95% CI: 1.378-37.044) but not stage T2 (P=0.435, OR=0.503, 95% CI: 0.089-2.824) disease. The overall incidence of lymph node metastasis was 44.9% (19.6% for T1, 23.6% for T2, 56.7% for T3, and 67.8% for T4). Patient age, sex, and tumour location did not significantly affect lymph node metastasis (LNM). The presence of LVI (OR=3.882, 95% CI=2.338-6.440, P=0.000), TD (OR=27.645, 95% CI=9.805-77.947, P=0.000), higher T stage (OR=1.969, 95% CI=1.471-2.635, P=0.000), and poorly differentiated histology (OR=2.255, 95% CI=1.544-3.293, P=0.000) were associated with a higher incidence of LNM on multivariate analysis. Perineural invasion (P=0.000) significantly affected LNM in univariate but not multivariate analysis (OR=1.213, 95% CI=0.734-2.003, P=0.452).Conclusion: There was no significant difference between male and female patients in onset age. Tumour location, PNI, LVI, TD, and differentiation grade were significantly related to pathologic T stage. Patients with the presence of LVI and TD, higher T stage, and poorly differentiated histology have a significantly higher chance of LNM.

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Treatment efficacy in patients with advanced biliary tract cancer receiving gemcitabine and cisplatin and 21-h infusional 5-FU: An analysis of 17 cases.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e15195 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e15195-e15195

Author(s):

Mozaffar Aznab ◽

Kiumars Eslam pia ◽

Khosro Setayeshi ◽

Mansour Rezaei ◽

Kaveh Kavianymoghadam

Keyword(s):

Lymph Node ◽

Liver Metastasis ◽

Gallbladder Cancer ◽

Biliary Tract ◽

Biliary Tract Cancer ◽

Medical Sciences ◽

Curative Surgery ◽

Local Invasion ◽

Tract Cancer ◽

Age Range

e15195 Background:Biliary tract a group of tumors which only a minority of patients is eligible for curative surgery. The purpose of this study was to identify efficacy treatment of gemcitabine, cisplatin, and 21h infusional 5-FU in patients with advanced BTC receiving this therapy, and the median time to progression and OS time. Methods: The data of 17 patients with advanced biliary tract cancer who referred to clinic oncology of Kermanshah University of Medical Sciences, which received treatment from January 2009 to December 2012 were collected. Patients with gallbladder cancer with local invasion into near structures or metastatic to lymph node and or liver and or peritoneal seeding and also patients with cholangiocarcinom were randomized to recieveing chemotherapy consisting of cycles of continuous infusion of 5-FU for 21-hours (600 mg/m2) days 1, 2, 3, and 4. Gemcitabine was given at dose of 1,250 mg/m2 days 1 and 8 and cisplatin was given at dose of 60 mg/m2 day 1 with G-csf every support. Each cycle repeated every 21 days for 6-7 cycles. Results: A total of 17 patients with age range 41-61 years studied.58.8% female and 41.2% were male. The 11 patients were gallbladder cancer with only local invasion into surrounding structures in 7 pts and 2 pts with only lymph node and peritoneal involving and 2 pts with lymph node and peritoneal involving and liver metastasis, and 6 patients were cholangiocarcinoma with lymph node and peritoneal involving in 3 pts and one pts with lymph node involving and one pts with liver metastasis. Four out of the 11 patients with gallbladder cancer with local invasion survived above 29 months one pts above 20 months. Means and medians for TTP of 6 pts which disease progressed was 11.2 and 9.6 months, respectively. Means for OS Time of 17 pts was 32 months. The overall 75.5% of pts are alive. This regimen was well tolerated, with neutropenia and thrombocytopenia as the most significant toxicities. Conclusions: The triple therapy with Gemcitabine cisplatin, 5-FU showed efficacy with manageable toxicity in patients with advanced BTC and demonstrated that the addition infusional 5-FU to cisplatin and gemcitabine afforded significant PFS and OS benefits.

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