Tumor location of extrahepatic cholangiocarcinoma (CCA) might influence survival after
resection.
A consecutive series of 175 patients who had undergone a potentially curative resection
of extrahepatic CCA was analyzed. We calculated concordance indices of different constructed
prognostic models for survival including TNM (tumour-node-metastasis) staging and
developed a nomogram of the most sensitive model.
Overall cancer-specific survival rates were 83%, 58%, and 26% at 1, 2, and 5 years,
respectively. Cancer-specific survival according to location was 42% for proximal,
23% for mid, and 19% for distal CCA after 5 years. Tumor location was not an independent
significant predictor (P = 0.06). A prognostic model using all potential prognostic
variables predicted survival better compared with TNM staging (concordance index 0.65
versus 0.63). A reduced model containing only lymph node status, microscopically residual
tumor status, and tumor differentiation grade, also outperformed TNM staging (concordance
index 0.66).
Tumor location of extrahepatic CCA does not independently predict cancer-specific
survival after resection. We developed a nomogram, based on a prognostic model with
lymph node status, microscopically residual tumor status of resection margins, and
tumor differentiation grade, that predicted survival better than TNM staging.