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Table 2 Chronological changes in clinical, operative, pathological characteristics and postoperative progression after PSM (* : matching factor)

From: Surgical outcomes and prognostic factors of distal common bile duct adenocarcinoma: chronological analysis in a single high-volume institutional experience

 

Early period

1995 ~ 2012 (n = 316)

Late period

2013 ~ 2018 (n = 316)

p-value

 

Clinical characteristics

    

 *Age

65.8 ± 7.9

66.0 ± 8.2

0.759

 

 *Sex

  

0.802

 

  Male

204 (64.6)

208 (65.8)

  

  Female

112 (35.4)

108 (34.2)

  

 *BMI (kg/m2)

23.1 ± 3.0

23.3 ± 2.9

0.602

 

 DM

  

0.447

 

  No

249 (78.8)

240 (75.9)

  

  Yes

67 (21.2)

76 (24.1)

  

 *ASA score

  

0.627

 

  1

51 (16.1)

42 (13.3)

  

  2

233 (73.7)

240 (75.9)

  

  3

32 (10.1)

34 (10.8)

  

  4

0 (0.0)

0 (0.0)

  

  Unknown

0 (0.0)

0 (0.0)

  

 Preoperative total bilirubin (mg/dL)

9.6 ± 9.2

7.4 ± 7.7

< 0.001

 

 Preoperative biliary drainage

  

0.041

 

  No

42 (13.3)

62 (19.6)

  

  Yes

274 (86.7)

254 (80.4)

  

 Preoperative CA19-9

  

0.001

 

\(\le\)37 U/mL

122 (38.6)

163 (51.6)

  

\(>\) 37 U/mL

188 (59.5)

141 (44.6)

  

  Unknown

6 (1.9)

12 (3.8)

  

Operative characteristics

    

 Operation type

  

0.010

 

  PPPD

193 (61.1)

228 (72.2)

  

  PRPD

103 (32.6)

68 (21.5)

  

  HPD

16 (5.1)

18 (5.7)

  

  TP

4 (1.3)

2 (0.6)

  

 Vascular resection

  

0.475

 

  No

302 (95.6)

297 (94.0)

  

  Yes

14 (4.4)

19 (6.0)

  

 Combined operation

  

0.624

 

  No

309 (97.8)

306 (96.8)

  

  Yes

7 (2.2)

10 (3.2)

  

 Operation duration (minutes)

335.4 ± 66.6

322.0 ± 65.4

0.011

 

 EBL (mL)

675.5 ± 721.5

393.5 ± 275.0

< 0.001

 

 Intraoperative transfusion

  

< 0.001

 

  No

238 (75.3)

294 (93.0)

  

  Yes

78 (24.7)

22 (7.0)

  

Pathological characteristics

    

 Tumor size

2.9 ± 1.5

2.8 ± 1.3

0.131

 

 T stage (AJCC 7th)

  

0.042

 
  

Tis

1 (0.3)

Tis

1 (0.3)

  
  

T1

25 (7.9)

T1

46 (14.6)

  
  

T2

83 (26.3)

T2

69 (21.8)

  
  

T3

206 (65.2)

T3

200 (63.3)

  
  

T4

1 (0.3)

T4

0 (0.0)

  

 Differentiation

  

< 0.001

 

  Well

47 (14.9)

30 (9.5)

  

  Moderately

164 (51.9)

190 (60.1)

  

  Poorly

82 (25.9)

89 (28.2)

  

  Undifferentiated

2 (0.6)

5 (1.6)

  

  Unknown

21 (6.6)

2 (0.6)

  

 N stage (AJCC 8th)

  

0.927

 

  N0

206 (65.2)

210 (66.5)

  

  N1

83 (26.3)

81 (25.6)

  

  N2

27 (8.5)

25 (7.9)

  

 Harvested LN

21.4 ± 10.7

19.3 ± 8.9

0.009

 

 Metastatic LN

1.1 ± 2.3

0.9 ± 2.0

0.358

 

 M stage

  

-

 

  M0

316 (100.0)

316 (100.0)

  

  M1

0 (0.0)

0 (0.0)

  

 Resection margin

  

0.435

 

  R0

294 (93.0)

287 (90.8)

  

  R1

21 (6.6)

26 (8.2)

  

  R2

1 (0.3)

3 (0.9)

  

 Perineural invasion

  

< 0.001

 

  No

42 (13.3)

67 (21.2)

  

  Yes

177 (56.0)

246 (77.8)

  

  Unknown

97 (30.7)

3 (0.9)

  

 Lymphovascular invasion

  

< 0.001

 

  No

27 (8.5)

179 (56.6)

  

  Yes

51 (16.1)

134 (42.4)

  

  Unknown

238 (75.3)

3 (0.9)

  

Postoperative progression

    

 Postoperative hospitalization (days)

19.8 ± 12.1

14.0 ± 7.5

< 0.001

 

 POPF

  

0.167

 

  No (biochemical leak)

270 (85.4)

281 (88.9)

  

  Grade B

37 (11.7)

32 (10.1)

  

  Grade C

9 (2.8)

3 (0.9)

  

 Clavien-Dindo classification

  

< 0.001

 

  No complication

160 (50.6)

166 (52.5)

  

  I

32 (10.1)

2 (0.6)

  

  II

46 (14.6)

63 (19.9)

  

  IIIa

51 (16.1)

60 (19.0)

  

  IIIb

12 (3.8)

8 (2.5)

  

  IVa

10 (3.2)

13 (4.1)

  

  IVb

0 (0.0)

1 (0.3)

  

  V

5 (1.6)

3 (0.9)

  

 In-hospital mortality (%)

4 (1.3)

2 (0.6)

0.412

 

 30-day mortality (%)

4 (1.3)

3 (0.9)

0.704

 

 90-day mortality (%)

8 (2.5)

6 (1.9)

0.589

 

 Adjuvant treatment

  

< 0.001

 

  No

274 (86.7)

211 (66.8)

  

  Yes

42 (13.3)

105 (33.2)

  
  1. Significant values are indicated in bold
  2. PSM Propensity score matching, BMI body mass index, DM Diabetes Mellitus, ASA American Society of Anesthesiologists, CA19-9 carbohydrate antigen 19-9, PPPD Pylorus preserving pancreaticoduodenectomy, PRPD Pylorus resecting pancreaticoduodenectomy, HPD hepaticopancreaticoduodenectomy, TP total pancreatectomy, EBL estimated blood loss, AJCC American Joint Committee Cancer, LN lymph node, PNI Perineural invasion, LVI Lymphovascular invasion, POPF Postoperative pancreatic fistula