Albumin-Bilirubin Grade and Tumor Burden Score Predict Outcomes Among Patients with Intrahepatic Cholangiocarcinoma After Hepatic Resection: a Multi-Institutional Analysis

被引：14

作者：

Munir, Muhammad Musaab ^{[1
]}

Endo, Yutaka ^{[1
]}

Lima, Henrique A. ^{[1
]}

Alaimo, Laura ^{[1
]}

Moazzam, Zorays ^{[1
]}

Shaikh, Chanza ^{[1
]}

Poultsides, George A. ^{[2
]}

Guglielmi, Alfredo ^{[3
]}

Aldrighetti, Luca ^{[4
]}

Weiss, Matthew ^{[5
]}

Bauer, Todd W. ^{[6
]}

Alexandrescu, Sorin ^{[7
]}

Kitago, Minoru ^{[8
]}

Maithel, Shishir K. ^{[9
]}

Marques, Hugo P. ^{[10
]}

Martel, Guillaume ^{[11
]}

Pulitano, Carlo ^{[12
]}

Shen, Feng ^{[13
]}

Cauchy, Francois ^{[14
]}

Koerkamp, Bas Groot ^{[15
]}

Endo, Itaru ^{[16
]}

Pawlik, Timothy M. ^{[1
,17
,18
]}

机构：

[1] Ohio State Univ Wexner Med Ctr, James Comprehens Canc Ctr, Dept Surg, Columbus, OH 43210 USA

[2] Stanford Univ, Dept Surg, Stanford, CA USA

[3] Univ Verona, Dept Surg, Verona, Italy

[4] Osped San Raffaele, Dept Surg, Milan, Italy

[5] Johns Hopkins Univ Hosp, Dept Surg, Baltimore, MA USA

[6] Univ Virginia, Dept Surg, Charlottesville, VA USA

[7] Fundeni Clin Inst, Dept Surg, Bucharest, Romania

[8] Keio Univ, Dept Surg, Tokyo, Japan

[9] Emory Univ, Dept Surg, Atlanta, GA USA

[10] Curry Cabral Hosp, Dept Surg, Lisbon, Portugal

[11] Univ Ottawa, Dept Surg, Ottawa, ON, Canada

[12] Univ Sydney, Royal Prince Alfred Hosp, Dept Surg, Sydney, Australia

[13] Eastern Hepatobiliary Surg Hosp, Dept Surg, Shanghai, Peoples R China

[14] Beaujon Hosp, Dept Hepatibiliopancreat Surg, APHP, Clichy, France

[15] Erasmus MC, Dept Surg, Rotterdam, Netherlands

[16] Univ Sch Med, Dept Gastroenterol Surg, Yokohama, Japan

[17] Urban Meyer III & Shelley Meyer Chair Canc Res, Dept Surg, Columbus, OH 43210 USA

[18] Ohio State Univ, Wexner Med Ctr, Hlth Serv Management & Policy, 395 W 12Th Ave, Suite 670, Columbus, OH 43210 USA

来源：

JOURNAL OF GASTROINTESTINAL SURGERY | 2023年 / 27卷 / 03期

关键词：

Intrahepatic cholangiocarcinoma; Tumor burden; Albumin-bilirubin grade; Overall survival; LONG-TERM SURVIVAL; LYMPH-NODE DISSECTION; HEPATOCELLULAR-CARCINOMA; PROGNOSTIC UTILITY; CLASSIFICATION; COMPLICATIONS; PATTERNS; NOMOGRAM;

D O I：

10.1007/s11605-023-05578-z

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

BackgroundThe prognostic role of tumor burden score (TBS) relative to albumin-bilirubin (ALBI) grade among patients undergoing curative-intent resection of ICC has not been examined.MethodsWe identified patients who underwent curative-intent resection for ICC between 1990 and 2017 from a multi-institutional database. Multivariable analysis was performed to assess the effect of TBS relative to ALBI grade on both short- and long-term outcomes.ResultsAmong 724 patients, 360 (49.7%) patients had low TBS and low ALBI grade, 142 (19.6%) patients had low TBS and high ALBI grade, 138 (19.1%) patients had high TBS and low ALBI grade, and 84 patients (11.6%) had high TBS and high ALBI grade. Decreased tumor burden was associated with better long-term outcomes among patients with both low (5-year OS; low TBS vs. high TBS: 52.4% vs 21.4%; p < 0.001) and high ALBI grade (5-year OS; low TBS vs. high TBS: 40.7% vs 12.0%; p < 0.001). On multivariable analysis, higher ALBI grade was associated with greater odds of an extended hospital LOS (> 10 days) (OR 2.80, 95%CI 1.62-4.82; p < 0.001), perioperative transfusion (OR 2.04, 95%CI 1.25-3.36; p = 0.005), 90-day mortality (OR 2.56, 95%CI 1.12-5.81; p = 0.025), as well as a major complication (OR 1.99, 95%CI 1.13-3.49; p = 0.016) among patients with similar tumor burden. Of note, patients with high TBS and high ALBI grade had markedly worse overall survival compared with patients who had low TBS and low ALBI grade disease (HR 2.27; 95%CI 1.44-3.59; p < 0.001). Importantly, high TBS and high ALBI grade were strongly associated with both early recurrence (88.1%%) and 5-year risk of death (96.4%).ConclusionBoth TBS (i.e., tumor morphology) and ALBI grade (i.e., hepatic function reserve) were strong predictors of outcomes among patients undergoing ICC resection. There was an interplay between TBS and ALBI grade relative to patient prognosis after hepatic resection of ICC with high ALBI grade predicting worse outcomes among ICC patients with different TBS.

引用

页码：544 / 554

页数：11

共 37 条

[1] The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging [J].

Amin, Mahul B. ;

Greene, Frederick L. ;

Edge, Stephen B. ;

Compton, Carolyn C. ;

Gershenwald, Jeffrey E. ;

Brookland, Robert K. ;

Meyer, Laura ;

Gress, Donna M. ;

Byrd, David R. ;

Winchester, David P. .

CA-A CANCER JOURNAL FOR CLINICIANS, 2017, 67 (02) :93-99

[2] Recurrent Intrahepatic Cholangiocarcinoma - Review [J].

Bekki, Yuki ;

Von Ahrens, Dagny ;

Takahashi, Hideo ;

Schwartz, Myron ;

Gunasekaran, Ganesh .

FRONTIERS IN ONCOLOGY, 2021, 11

[3] Cholangiocarcinoma: Current Knowledge and New Developments [J].

Blechacz, Boris .

GUT AND LIVER, 2017, 11 (01) :13-26

[4] The impact of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio among patients with intrahepatic cholangiocarcinoma [J].

Buettner, Stefan ;

Spolverato, Gaya ;

Kimbrough, Charles W. ;

Alexandrescu, Sorin ;

Marques, Hugo P. ;

Lamelas, Jorge ;

Aldrighetti, Luca ;

Gamblin, T. Clark ;

Maithel, Shishir K. ;

Pulitano, Carlo ;

Weiss, Matthew ;

Bauer, Todd W. ;

Shen, Feng ;

Poultsides, George A. ;

Marsh, J. Wallis ;

IJzermans, Jan N. M. ;

Koerkamp, Bas Groot ;

Pawlik, Timothy M. .

SURGERY, 2018, 164 (03) :411-418

[5] Performance of prognostic scores and staging systems in predicting long-term survival outcomes after surgery for intrahepatic cholangiocarcinoma [J].

Buettner, Stefan ;

Galjart, Boris ;

van Vugt, Jeroen L. A. ;

Bagante, Fabio ;

Alexandrescu, Sorin ;

Marques, Hugo P. ;

Lamelas, Jorge ;

Aldrighetti, Luca ;

Gamblin, T. Clark ;

Maithel, Shishir K. ;

Pulitano, Carlo ;

Margonis, Georgios A. ;

Weiss, Matthew ;

Bauer, Todd W. ;

Shen, Feng ;

Poultsides, George A. ;

Marsh, J. Wallis ;

IJzermans, Jan N. M. ;

Koerkamp, Bas Groot ;

Pawlik, Timothy M. .

JOURNAL OF SURGICAL ONCOLOGY, 2017, 116 (08) :1085-1095

[6] Intrahepatic Cholangiocarcinoma: An International Multi-Institutional Analysis of Prognostic Factors and Lymph Node Assessment [J].

de Jong, Mechteld C. ;

Nathan, Hari ;

Sotiropoulos, Georgios C. ;

Paul, Andreas ;

Alexandrescu, Sorin ;

Marques, Hugo ;

Pulitano, Carlo ;

Barroso, Eduardo ;

Clary, Bryan M. ;

Aldrighetti, Luca ;

Ferrone, Cristina R. ;

Zhu, Andrew X. ;

Bauer, Todd W. ;

Walters, Dustin M. ;

Gamblin, T. Clark ;

Nguyen, Kevin T. ;

Turley, Ryan ;

Popescu, Irinel ;

Hubert, Catherine ;

Meyer, Stephanie ;

Schulick, Richard D. ;

Choti, Michael A. ;

Gigot, Jean-Francois ;

Mentha, Gilles ;

Pawlik, Timothy M. .

JOURNAL OF CLINICAL ONCOLOGY, 2011, 29 (23) :3140-3145

[7] Classification of surgical complications - A new proposal with evaluation in a cohort of 6336 patients and results of a survey [J].

Dindo, D ;

Demartines, N ;

Clavien, PA .

ANNALS OF SURGERY, 2004, 240 (02) :205-213

[8] Patterns of Discordance Between Pretransplant Imaging Stage of Hepatocellular Carcinoma and Posttransplant Pathologic Stage: A Contemporary Appraisal of the Milan Criteria [J].

Ecker, Brett L. ;

Hoteit, Maarouf A. ;

Forde, Kimberly A. ;

Hsu, Christine C. ;

Reddy, K. Rajender ;

Furth, Emma E. ;

Siegelman, Evan S. ;

Habibollahi, Peiman ;

Ben-Josef, Edgar ;

Porrett, Paige M. ;

Abt, Peter L. ;

Shaked, Abraham ;

Olthoff, Kim M. ;

Levine, Matthew H. .

TRANSPLANTATION, 2018, 102 (04) :648-655

[9] Impact of Tumor Burden Score on Conditional Survival after Curative-Intent Resection for Hepatocellular Carcinoma: A Multi-Institutional Analysis [J].

Elfadaly, Ahmed N. ;

Tsilimigras, Diamantis, I ;

Hyer, J. Madison ;

Paro, Alessandro ;

Bagante, Fabio ;

Ratti, Francesca ;

Marques, Hugo P. ;

Soubrane, Olivier ;

Lam, Vincent ;

Poultsides, George A. ;

Popescu, Irinel ;

Alexandrescu, Sorin ;

Martel, Guillaume ;

Workneh, Aklile ;

Guglielmi, Alfredo ;

Hugh, Tom ;

Aldrighetti, Luca ;

Endo, Itaru ;

Pawlik, Timothy M. .

WORLD JOURNAL OF SURGERY, 2021, 45 (11) :3438-3448

[10] Intrahepatic cholangiocardnoma - Rising frequency, improved survival, and determinants of outcome after resection [J].

Endo, Itaru ;

Gonen, Mithat ;

Yopp, Adam C. ;

Dalal, Kimberly M. ;

Zhou, Qin ;

Klimstra, David ;

DAngelica, Michael ;

DeMatteo, Ronald P. ;

Fong, Yuman ;

Schwartz, Lawrence ;

Kemeny, Nancy ;

O'Reilly, Eileen ;

Abou-Alfa, Ghassan K. ;

Shimada, Hiroshi ;

Blumgart, Leslie H. ;

Jarnagin, William R. .

ANNALS OF SURGERY, 2008, 248 (01) :84-96

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