Preoperative Risk Classification for Early Recurrence After Curative-Intent Resection of Perihilar Cholangiocarcinoma: A Single-Center Retrospective Study
- 1Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
Abstract
Background/Objectives: Early recurrence (ER) after curative-intent resection of perihilar cholangiocarcinoma (PHC) is associated with poor prognosis. However, simple preoperative predictors remain insufficiently defined. This study aimed to identify preoperative factors associated with ER and explore a risk classification. Methods: We retrospectively analyzed 108 patients who underwent curative-intent resection for PHC at a single institution between 2007 and 2023. ER was defined as recurrence within 1 year after surgery. Cox proportional hazards regression was used to identify associated factors. Results: ER occurred in 24 patients (22.2%). Multivariable analysis identified younger age (hazard ratio [HR] = 0.942), higher carcinoembryonic antigen (CEA; HR = 1.115), higher carbohydrate antigen 19-9 (CA19-9; HR = 1.001), and higher neutrophil-to-lymphocyte ratio (NLR; HR = 1.404) as factors associated with ER. In an exploratory classification, one point was assigned for age < 61 years, CEA ≥ 5.4 ng/mL, CA19-9 ≥ 89.4 U/mL, and NLR ≥ 2.037. Among 105 patients with complete data, the estimated 1-year recurrence rate was 70.0% in patients with 3–4 points (n = 10), versus 17.4% in those with 0–2 points (n = 95; p < 0.001). Bootstrap analysis suggested optimism in the score’s apparent discrimination when cutoff optimization was considered (optimism-corrected C-index, 0.668). Conclusions: Age, CEA, CA19-9, and NLR were associated with ER after PHC resection. The exploratory classification requires external validation before clinical use.
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BibTeX
@article{fujimura2026preoperative,
title = {{Preoperative Risk Classification for Early Recurrence After Curative-Intent Resection of Perihilar Cholangiocarcinoma: A Single-Center Retrospective Study}},
author = {Yu Fujimura and Naohisa Kuriyama and Yuki Segi and Haruna Komatsubara and Kazuyuki Gyoten and Takahiro Ito and Aoi Hayasaki and Takehiro Fujii and Yusuke Iizawa and Yasuhiro Murata and Akihiro Tanemura and Masashi Kishiwada and Shugo Mizuno},
journal = {Cancers},
year = {2026},
month = nov,
doi = {10.3390/cancers18213568},
url = {https://www.mdpi.com/2072-6694/18/21/3568},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Preoperative Risk Classification for Early Recurrence After Curative-Intent Resection of Perihilar Cholangiocarcinoma: A Single-Center Retrospective Study
AU - Yu Fujimura
AU - Naohisa Kuriyama
AU - Yuki Segi
AU - Haruna Komatsubara
AU - Kazuyuki Gyoten
AU - Takahiro Ito
AU - Aoi Hayasaki
AU - Takehiro Fujii
AU - Yusuke Iizawa
AU - Yasuhiro Murata
AU - Akihiro Tanemura
AU - Masashi Kishiwada
AU - Shugo Mizuno
PY - 2026
DA - 2026/11/06
JO - Cancers
DO - 10.3390/cancers18213568
UR - https://www.mdpi.com/2072-6694/18/21/3568
AB - Background/Objectives: Early recurrence (ER) after curative-intent resection of perihilar cholangiocarcinoma (PHC) is associated with poor prognosis. However, simple preoperative predictors remain insufficiently defined. This study aimed to identify preoperative factors associated with ER and explore a risk classification. Methods: We retrospectively analyzed 108 patients who underwent curative-intent resection for PHC at a single institution between 2007 and 2023. ER was defined as recurrence within 1 year after surgery. Cox proportional hazards regression was used to identify associated factors. Results: ER occurred in 24 patients (22.2%). Multivariable analysis identified younger age (hazard ratio [HR] = 0.942), higher carcinoembryonic antigen (CEA; HR = 1.115), higher carbohydrate antigen 19-9 (CA19-9; HR = 1.001), and higher neutrophil-to-lymphocyte ratio (NLR; HR = 1.404) as factors associated with ER. In an exploratory classification, one point was assigned for age < 61 years, CEA ≥ 5.4 ng/mL, CA19-9 ≥ 89.4 U/mL, and NLR ≥ 2.037. Among 105 patients with complete data, the estimated 1-year recurrence rate was 70.0% in patients with 3–4 points (n = 10), versus 17.4% in those with 0–2 points (n = 95; p < 0.001). Bootstrap analysis suggested optimism in the score’s apparent discrimination when cutoff optimization was considered (optimism-corrected C-index, 0.668). Conclusions: Age, CEA, CA19-9, and NLR were associated with ER after PHC resection. The exploratory classification requires external validation before clinical use.
SN - 2072-6694
ER -