Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 16, 2021; 9(32): 9770-9782
Published online Nov 16, 2021. doi: 10.12998/wjcc.v9.i32.9770
Risk factors for occult metastasis detected by inflammation-based prognostic scores and tumor markers in biliary tract cancer
Yu Hashimoto, Tetsuo Ajiki, Hiroaki Yanagimoto, Daisuke Tsugawa, Kenta Shinozaki, Hirochika Toyama, Masahiro Kido, Takumi Fukumoto
Yu Hashimoto, Tetsuo Ajiki, Hiroaki Yanagimoto, Daisuke Tsugawa, Kenta Shinozaki, Hirochika Toyama, Masahiro Kido, Takumi Fukumoto, Department of Surgery, Division of Hepato-Biliary-Pancreatic SurgeryKobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan
Author contributions: Ajiki T and Hashimoto Y designed and performed the research and wrote the paper; Yanagimoto H and Tsugawa D contributed to the analysis; Shinozaki K collected the clinical data; Toyama H and Kido M provided clinical advice; Fukumoto T supervised the report.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Kobe University Graduate School of Medicine (#160163).
Informed consent statement: Informed consent was obtained using the opt-out principle. For full disclosure, the details of the study are published on the home page of Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine.
Conflict-of-interest statement: The authors declare that they have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tetsuo Ajiki, MD, Professor, Department of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan. ajiki@med.kobe-u.ac.jp
Received: May 25, 2021
Peer-review started: May 25, 2021
First decision: July 3, 2021
Revised: July 13, 2021
Accepted: September 22, 2021
Article in press: September 22, 2021
Published online: November 16, 2021
Core Tip

Core Tip: This is a retrospective study to clarify the risk factors for occult metastasis in patients with biliary tract cancer (BTC). Radiological detection of small liver metastasis or peritoneal metastasis is difficult, and 11% BTC patients resulted in exploratory laparotomy in 7 years. Serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 levels, neutrophil-lymphocyte ratio and modified Glasgow prognostic score were significantly higher in the exploratory laparotomy group than in resected group. In these, CEA > 7 ng/mL and a combination of these factors were useful for predicting occult metastasis in BTC. Based on these factors, selective staging laparoscopy may reduce the rate of exploratory laparotomy.