The First Part Is A Clinical Study Of Prognostic Indicators For Patients With Distal Cholangiocarcinoma After Radical Surgical Resection. The Second Part Is The Preoperative Platelet-lymphocyte Ratio As An Independent Prognostic Factor For Patients With A

BackgroundWhether log of odds between the number of positive lymph node and the number of negative lymph node(LODDS)predict lymph node status and oncological outcomes for distal extrahepatic Cholangiocarcinoma(dECA)patients after curative resection remains rarely studied.Methods743 patients from SEER database between 2004 and 2014 and 90 patients from PUMCH for dECA between 2010 and 2017 who received curative pancreato-duodenectomy(PD)were analyzed.We conducted random survival forests analysis(RSF)and receiver operating characteristic(ROC)curve and univariate(Log-Rank)and multivariate(Cox regression)analysis to identify the diagnostic and prognostic roles of LODDS.ResultsLODDS was the variable with the highest area under the ROC curve(AUC)for prediction of 3-year survival(AUC=0.679),followed by PLR(AUC=0.623,0.514 to 0.724),NLN(AUC=0.617),and UICC/AJCC8 pN stage(AUC=0.612),number of TLNs(AUC=0.583),UICC/AJCC7 pN stage(AUC=0.569).The number of PLNs,LNR,and LODDS appear to better predict survival than the UICC/AJCC pN stage in patients undergoing curative surgery for dECA.We determined the optimum cut-off value of LODDS and LODDS<=-1.0598,Total resected lymph node(RLNs)RLN<=9 by ROC curve.We defined the patients as high-and low-LODDS.A total of 90 patients including 59 eligible patients(65.6%)with low-LODDS compared with 31(34.4%)stratified in high-LODDS groups.Significant predictors of overall survival reduction in single-factor survival analysis were lymph node metastasis(P=0.029),surgical margin status(P=0.0378),and LODDS(P=0.0005);disease-free survival prognostic factors and overall survival prediction The factors were the same,including lymph node metastasis(P=0.0123),surgical margin(P=0.0265),and LODDS(P=0.0008).In multivariate analysis,only LODDS(hazard ratio(HR)=2.8196,95%CI 1.4918-5.3293,P=0.0014)was independent prognostic factor for OS and DFS.ConclusionLODDS was proved to better predict for lymph node and survival as an independent indictor for OS and DFS in dECA After Radical Surgical Resection.BackgroundThe issue of whether perioperative allogeneic blood transfusion adversely influence oncological outcomes of distal extrahepatic cholangiocarcinoma patients after curative resection has rarely been studied.MethodThe cohort of this retrospective,single center,observational study comprised 90 patients who underwent curative pancreatoduodenectomy for distal extrahepatic cholangiocarcinoma between 2010 and 2017.Relevant data were assessed by Cox regression,variable selection logistic regression,propensity score analysis,and subgroup analysis.ResultsOf the 90 study patients,55(61.1%)received allogeneic blood transfusions and 35(38.9%)cases did not.According to Kaplan-Meier survival and Cox regression risk model analysis,allogeneic blood transfusion was not a prognostic factor for overall(HR=1.5834;95%CI,0.7923-3.1643;P=0.1933)or disease-free survival(HR=1.289,95%CI,0.632-2.627;P=0.485).After adjusting the data according to propensity score analysis,allogeneic blood transfusion was still not associated with overall(HR=0.9716;95%CI,0.375-2.5113;P=0.9526)or disease-free survival(HR=1.2835;95%CI,0.5403-3.0488;P=0.5718).In subgroup analysis,allogeneic blood transfusion proved to be a potential dependent negative prognostic factor for disease-free survival in patients with stage Ⅱb disease(HR=3.331;95%CI,1.208-9.187;P=0.020).ConclusionPerioperative allogeneic blood transfusion does not affect the prognosis of distal extrahepatic cholangiocarcinoma after radical surgical resection.However,it is a potential dependent poor prognostic factor for disease-free survival for the Ⅱb stage patients.BackgroundThe objective of this study was to evaluate whether preoperative platelet-lymphocyte ratio(PLR)and neutrophil-lymphocyte ratio(NLR)could predict the prognosis for curative resected ampullary carcinoma.MethodsA total of 97 patients were retrospectively collected over a 6-year period in which consecutive cases underwent pancreaticoduodenectomy for ampullary malignancy.ResultsPreoperative blood results were available in the 96 cases of resected ampullary carcinoma.Preoperative PLR and NLR cut-off value 226.8 and 2.58 were determined to represent the optimal cut-off values to the cases in survival analysis.PLR Still being a significant independent predictor of survival in multivariate analysis(Cox,p<0.001)along with tumor differentiation(p<0.001),nodal status(p<0.001)and stage(p<0.001).While NLR failed to be as a prognostic factor both in univariate(P=)and multivariate(p)survival analysis.Besides,the nodal involvement rate was higher in high PLR group(56.52 percentage VS.30.43 percentage,p=0.025).ConclusionPreoperative PLR and NLR merit further evaluation as a prognostic index in curative resected ampullary carcinoma.And,it is a candidate predictor for the lymph node metastasis.