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The MEGNA Score and Preoperative Anemia are Major Prognostic Factors After Resection in the German Intrahepatic Cholangiocarcinoma Cohort.
Schnitzbauer, Andreas A; Eberhard, Johannes; Bartsch, Fabian; Brunner, Stefan M; Ceyhan, Güralp O; Walter, Dirk; Fries, Helmut; Hannes, Sabine; Hecker, Andreas; Li, Jun; Oldhafer, Karl; Rahbari, Nuh; Rauchfuss, Falk; Schlitt, Hans J; Settmacher, Utz; Stavrou, Gregor; Weitz, Jürgen; Lang, Hauke; Bechstein, Wolf O; Rückert, Felix.
Afiliación
  • Schnitzbauer AA; Department of General and Visceral Surgery, University Hospital Frankfurt, Goethe-University Frankfurt, Frankfurt/Main, Germany. andreas.schnitzbauer@kgu.de.
  • Eberhard J; Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
  • Bartsch F; Department of General, Visceral and Transplantation Surgery, University Hospital of Mainz, Mainz, Germany.
  • Brunner SM; Department of Surgery, Regensburg University Medical Center, Regensburg, Germany.
  • Ceyhan GO; Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
  • Walter D; Department for Medicine I, University Hospital Frankfurt, Goethe-University Frankfurt, Frankfurt/Main, Germany.
  • Fries H; Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
  • Hannes S; Department of General and Visceral Surgery, University Hospital Frankfurt, Goethe-University Frankfurt, Frankfurt/Main, Germany.
  • Hecker A; Department of General and Thoracic Surgery, University Hospital of Giessen, Giessen, Germany.
  • Li J; Department of General, Visceral and Thoracic Surgery, University Medical Centre, Hamburg-Eppendorf, Hamburg, Germany.
  • Oldhafer K; Department of General and Abdominal Surgery, Faculty of Medicine, Asklepios Hospital Barmbek, Semmelweis University Campus, Hamburg, Germany.
  • Rahbari N; Department of Gastrointestinal, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
  • Rauchfuss F; Department of General, Visceral and Vascular Surgery, Jena University Hospital, Jena, Germany.
  • Schlitt HJ; Department of Surgery, Regensburg University Medical Center, Regensburg, Germany.
  • Settmacher U; Department of General, Visceral and Vascular Surgery, Jena University Hospital, Jena, Germany.
  • Stavrou G; Department of General and Abdominal Surgery, Faculty of Medicine, Asklepios Hospital Barmbek, Semmelweis University Campus, Hamburg, Germany.
  • Weitz J; Department of Gastrointestinal, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
  • Lang H; Department of General, Visceral and Transplantation Surgery, University Hospital of Mainz, Mainz, Germany.
  • Bechstein WO; Department of General and Visceral Surgery, University Hospital Frankfurt, Goethe-University Frankfurt, Frankfurt/Main, Germany.
  • Rückert F; Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Ann Surg Oncol ; 27(4): 1147-1155, 2020 Apr.
Article en En | MEDLINE | ID: mdl-31646454
BACKGROUND: Surgical resection is associated with the best long-term results for intrahepatic cholangiocarcinoma (ICC); however, long-term outcomes are still poor. OBJECTIVE: The primary aim of this study was to validate the recently proposed MEGNA score and to identify additional prognostic factors influencing short- and long-term survival. PATIENTS AND METHODS: This was a retrospective analysis of a German multicenter cohort operated at 10 tertiary centers from 2004 to 2013. Patients were clustered using the MEGNA score and overall survival was analyzed. Cox regression analysis was used to identify prognostic factors for both overall and 90-day survival. RESULTS: A total of 488 patients undergoing liver resection for ICC fulfilled the inclusion criteria and underwent analysis. Median age was 67 years, 72.5% of patients underwent major hepatic resection, and the lymphadenectomy rate was 86.9%. Median overall survival was 32.2 months. The MEGNA score significantly discriminated the long-term overall survival: 0 (68%), I (48%), II (32%), and III (19%) [p <0.001]. In addition, anemia was an independent prognostic factor for overall survival (hazard ratio 1.78, 95% confidence interval 1.29-2.45; p <0.01). CONCLUSION: Hepatic resection provides the best long-term survival in all risk groups (19-65% overall survival). The MEGNA score is a good discriminator using histopathologic items and age for stratification. Correction of anemia should be attempted in every patient who responds to treatment. Perioperative liver failure remains a clinical challenge and contributes to a relevant number of perioperative deaths.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de los Conductos Biliares / Colangiocarcinoma / Anemia / Oncología Médica Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2020 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de los Conductos Biliares / Colangiocarcinoma / Anemia / Oncología Médica Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Ann Surg Oncol Asunto de la revista: NEOPLASIAS Año: 2020 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos