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A proposed severity classification system for hepatolithiasis based on an analysis of prognostic factors in a Japanese patient cohort
Background Hepatolithiasis frequently results in severe complications. We conducted a cohort study to identify prognostic factors and to establish a hepatolithiasis severity classification system. Methods The study cohort comprised 396 patients who were identified through a 1998 nationwide survey an...
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| Published in: | Journal of gastroenterology 2018-07, Vol.53 (7), p.854-860 |
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| container_end_page | 860 |
| container_issue | 7 |
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| container_title | Journal of gastroenterology |
| container_volume | 53 |
| creator | Suzuki, Yutaka Mori, Toshiyuki Yokoyama, Masaaki Kim, Sangchul Momose, Hirokazu Matsuki, Ryota Kogure, Masaharu Abe, Nobutsugu Isayama, Hiroyuki Nakazawa, Takahiro Notohara, Kenji Tanaka, Atsushi Tsuyuguchi, Toshio Tazuma, Susumu Takikawa, Hajime Sugiyama, Masanori |
| description | Background
Hepatolithiasis frequently results in severe complications. We conducted a cohort study to identify prognostic factors and to establish a hepatolithiasis severity classification system.
Methods
The study cohort comprised 396 patients who were identified through a 1998 nationwide survey and followed up for 18 years or until death. Cox regression analysis was used to identify prognostic factors.
Results
Median survival time of the patients was 308 (range 0–462) months. Of the 396 patients enrolled in the study, 118 (29.8%) died, most frequently from intrahepatic cholangiocarcinoma (25 patients, 21.2%). Age of ≥ 65 years at the time of initial diagnosis [hazard ratio (HR) 3.410], jaundice for ≥ 1 week during follow-up (HR 2.442), intrahepatic cholangiocarcinoma (HR 3.674), and liver cirrhosis (HR 5.061) were shown to be significant risk factors for death from any therapeutic course. The data led to a 3-grade disease severity classification system that incorporates intrahepatic cholangiocarcinoma and liver cirrhosis as major factors and age of ≥ 65 years and jaundice for ≥ 1 week during follow-up as minor factors. Survival rates differed significantly between grades.
Conclusions
The proposed hepatolithiasis severity classification system can be used to assess prognosis and thereby improve patient outcomes. |
| doi_str_mv | 10.1007/s00535-017-1410-6 |
| format | article |
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Hepatolithiasis frequently results in severe complications. We conducted a cohort study to identify prognostic factors and to establish a hepatolithiasis severity classification system.
Methods
The study cohort comprised 396 patients who were identified through a 1998 nationwide survey and followed up for 18 years or until death. Cox regression analysis was used to identify prognostic factors.
Results
Median survival time of the patients was 308 (range 0–462) months. Of the 396 patients enrolled in the study, 118 (29.8%) died, most frequently from intrahepatic cholangiocarcinoma (25 patients, 21.2%). Age of ≥ 65 years at the time of initial diagnosis [hazard ratio (HR) 3.410], jaundice for ≥ 1 week during follow-up (HR 2.442), intrahepatic cholangiocarcinoma (HR 3.674), and liver cirrhosis (HR 5.061) were shown to be significant risk factors for death from any therapeutic course. The data led to a 3-grade disease severity classification system that incorporates intrahepatic cholangiocarcinoma and liver cirrhosis as major factors and age of ≥ 65 years and jaundice for ≥ 1 week during follow-up as minor factors. Survival rates differed significantly between grades.
Conclusions
The proposed hepatolithiasis severity classification system can be used to assess prognosis and thereby improve patient outcomes.</description><identifier>ISSN: 0944-1174</identifier><identifier>EISSN: 1435-5922</identifier><identifier>DOI: 10.1007/s00535-017-1410-6</identifier><identifier>PMID: 29119290</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Abdominal Surgery ; Analysis ; Biliary Tract ; Cholangiocarcinoma ; Cirrhosis ; Classification ; Cohort analysis ; Colorectal Surgery ; Diagnosis ; Gastroenterology ; Health aspects ; Hepatology ; Jaundice ; Liver ; Liver cirrhosis ; Medical prognosis ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Original Article—Liver ; Pancreas ; Patients ; Risk factors ; Surgical Oncology ; Surveys ; Survival</subject><ispartof>Journal of gastroenterology, 2018-07, Vol.53 (7), p.854-860</ispartof><rights>Japanese Society of Gastroenterology 2017</rights><rights>COPYRIGHT 2018 Springer</rights><rights>Journal of Gastroenterology is a copyright of Springer, (2017). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c463t-aa727566373edfc969cb7f29b5a8c15b1f160340e082eec7d70b999271efaed23</citedby><cites>FETCH-LOGICAL-c463t-aa727566373edfc969cb7f29b5a8c15b1f160340e082eec7d70b999271efaed23</cites><orcidid>0000-0002-2603-5688</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29119290$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Suzuki, Yutaka</creatorcontrib><creatorcontrib>Mori, Toshiyuki</creatorcontrib><creatorcontrib>Yokoyama, Masaaki</creatorcontrib><creatorcontrib>Kim, Sangchul</creatorcontrib><creatorcontrib>Momose, Hirokazu</creatorcontrib><creatorcontrib>Matsuki, Ryota</creatorcontrib><creatorcontrib>Kogure, Masaharu</creatorcontrib><creatorcontrib>Abe, Nobutsugu</creatorcontrib><creatorcontrib>Isayama, Hiroyuki</creatorcontrib><creatorcontrib>Nakazawa, Takahiro</creatorcontrib><creatorcontrib>Notohara, Kenji</creatorcontrib><creatorcontrib>Tanaka, Atsushi</creatorcontrib><creatorcontrib>Tsuyuguchi, Toshio</creatorcontrib><creatorcontrib>Tazuma, Susumu</creatorcontrib><creatorcontrib>Takikawa, Hajime</creatorcontrib><creatorcontrib>Sugiyama, Masanori</creatorcontrib><title>A proposed severity classification system for hepatolithiasis based on an analysis of prognostic factors in a Japanese patient cohort</title><title>Journal of gastroenterology</title><addtitle>J Gastroenterol</addtitle><addtitle>J Gastroenterol</addtitle><description>Background
Hepatolithiasis frequently results in severe complications. We conducted a cohort study to identify prognostic factors and to establish a hepatolithiasis severity classification system.
Methods
The study cohort comprised 396 patients who were identified through a 1998 nationwide survey and followed up for 18 years or until death. Cox regression analysis was used to identify prognostic factors.
Results
Median survival time of the patients was 308 (range 0–462) months. Of the 396 patients enrolled in the study, 118 (29.8%) died, most frequently from intrahepatic cholangiocarcinoma (25 patients, 21.2%). Age of ≥ 65 years at the time of initial diagnosis [hazard ratio (HR) 3.410], jaundice for ≥ 1 week during follow-up (HR 2.442), intrahepatic cholangiocarcinoma (HR 3.674), and liver cirrhosis (HR 5.061) were shown to be significant risk factors for death from any therapeutic course. The data led to a 3-grade disease severity classification system that incorporates intrahepatic cholangiocarcinoma and liver cirrhosis as major factors and age of ≥ 65 years and jaundice for ≥ 1 week during follow-up as minor factors. Survival rates differed significantly between grades.
Conclusions
The proposed hepatolithiasis severity classification system can be used to assess prognosis and thereby improve patient outcomes.</description><subject>Abdominal Surgery</subject><subject>Analysis</subject><subject>Biliary Tract</subject><subject>Cholangiocarcinoma</subject><subject>Cirrhosis</subject><subject>Classification</subject><subject>Cohort analysis</subject><subject>Colorectal Surgery</subject><subject>Diagnosis</subject><subject>Gastroenterology</subject><subject>Health aspects</subject><subject>Hepatology</subject><subject>Jaundice</subject><subject>Liver</subject><subject>Liver cirrhosis</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Original Article—Liver</subject><subject>Pancreas</subject><subject>Patients</subject><subject>Risk factors</subject><subject>Surgical Oncology</subject><subject>Surveys</subject><subject>Survival</subject><issn>0944-1174</issn><issn>1435-5922</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kV-L1DAUxYso7rj6AXyRgC--dL1J06Z5HJb1Hwu-6HNI05uZLG0z5maE-QB-b1NmdVGUBAI3v3M4l1NVLzlccQD1lgDapq2Bq5pLDnX3qNpwWSatFuJxtQEtZc25khfVM6I7AN5A2z-tLoTmXAsNm-rHlh1SPETCkRF-xxTyibnJEgUfnM0hLoxOlHFmPia2x4PNcQp5HywFYoNdhYWx67XTaR1Gv3rulkg5OOatyzERC4Vgn-zBLkjIik3AJTMX9zHl59UTbyfCF_fvZfX13c2X6w_17ef3H6-3t7WTXZNra5VQbdc1qsHRO91pNygv9NDa3vF24J530EhA6AWiU6OCQWstFEdvcRTNZfXm7FvyfTsiZTMHcjhNJVQ8kuG6E1J0IFVBX_-F3sVjKiuSEVAyCNFD_0Dt7IQmLD7mZN1qaraKy7ZvGrFSV_-gyhlxDi4u6EOZ_yHgZ4FLkSihN4cUZptOhoNZqzfn6k2p3qzVm65oXt0HPg4zjr8Vv7ougDgDVL6WHaaHjf7v-hN-5rmM</recordid><startdate>20180701</startdate><enddate>20180701</enddate><creator>Suzuki, Yutaka</creator><creator>Mori, Toshiyuki</creator><creator>Yokoyama, Masaaki</creator><creator>Kim, Sangchul</creator><creator>Momose, Hirokazu</creator><creator>Matsuki, Ryota</creator><creator>Kogure, Masaharu</creator><creator>Abe, Nobutsugu</creator><creator>Isayama, Hiroyuki</creator><creator>Nakazawa, Takahiro</creator><creator>Notohara, Kenji</creator><creator>Tanaka, Atsushi</creator><creator>Tsuyuguchi, Toshio</creator><creator>Tazuma, Susumu</creator><creator>Takikawa, Hajime</creator><creator>Sugiyama, Masanori</creator><general>Springer Japan</general><general>Springer</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2603-5688</orcidid></search><sort><creationdate>20180701</creationdate><title>A proposed severity classification system for hepatolithiasis based on an analysis of prognostic factors in a Japanese patient cohort</title><author>Suzuki, Yutaka ; Mori, Toshiyuki ; Yokoyama, Masaaki ; Kim, Sangchul ; Momose, Hirokazu ; Matsuki, Ryota ; Kogure, Masaharu ; Abe, Nobutsugu ; Isayama, Hiroyuki ; Nakazawa, Takahiro ; Notohara, Kenji ; Tanaka, Atsushi ; Tsuyuguchi, Toshio ; Tazuma, Susumu ; Takikawa, Hajime ; Sugiyama, Masanori</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c463t-aa727566373edfc969cb7f29b5a8c15b1f160340e082eec7d70b999271efaed23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Abdominal Surgery</topic><topic>Analysis</topic><topic>Biliary Tract</topic><topic>Cholangiocarcinoma</topic><topic>Cirrhosis</topic><topic>Classification</topic><topic>Cohort analysis</topic><topic>Colorectal Surgery</topic><topic>Diagnosis</topic><topic>Gastroenterology</topic><topic>Health aspects</topic><topic>Hepatology</topic><topic>Jaundice</topic><topic>Liver</topic><topic>Liver cirrhosis</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Original Article—Liver</topic><topic>Pancreas</topic><topic>Patients</topic><topic>Risk factors</topic><topic>Surgical Oncology</topic><topic>Surveys</topic><topic>Survival</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Suzuki, Yutaka</creatorcontrib><creatorcontrib>Mori, Toshiyuki</creatorcontrib><creatorcontrib>Yokoyama, Masaaki</creatorcontrib><creatorcontrib>Kim, Sangchul</creatorcontrib><creatorcontrib>Momose, Hirokazu</creatorcontrib><creatorcontrib>Matsuki, Ryota</creatorcontrib><creatorcontrib>Kogure, Masaharu</creatorcontrib><creatorcontrib>Abe, Nobutsugu</creatorcontrib><creatorcontrib>Isayama, Hiroyuki</creatorcontrib><creatorcontrib>Nakazawa, Takahiro</creatorcontrib><creatorcontrib>Notohara, Kenji</creatorcontrib><creatorcontrib>Tanaka, Atsushi</creatorcontrib><creatorcontrib>Tsuyuguchi, Toshio</creatorcontrib><creatorcontrib>Tazuma, Susumu</creatorcontrib><creatorcontrib>Takikawa, Hajime</creatorcontrib><creatorcontrib>Sugiyama, Masanori</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest 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gastroenterology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Suzuki, Yutaka</au><au>Mori, Toshiyuki</au><au>Yokoyama, Masaaki</au><au>Kim, Sangchul</au><au>Momose, Hirokazu</au><au>Matsuki, Ryota</au><au>Kogure, Masaharu</au><au>Abe, Nobutsugu</au><au>Isayama, Hiroyuki</au><au>Nakazawa, Takahiro</au><au>Notohara, Kenji</au><au>Tanaka, Atsushi</au><au>Tsuyuguchi, Toshio</au><au>Tazuma, Susumu</au><au>Takikawa, Hajime</au><au>Sugiyama, Masanori</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A proposed severity classification system for hepatolithiasis based on an analysis of prognostic factors in a Japanese patient cohort</atitle><jtitle>Journal of gastroenterology</jtitle><stitle>J Gastroenterol</stitle><addtitle>J Gastroenterol</addtitle><date>2018-07-01</date><risdate>2018</risdate><volume>53</volume><issue>7</issue><spage>854</spage><epage>860</epage><pages>854-860</pages><issn>0944-1174</issn><eissn>1435-5922</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Background
Hepatolithiasis frequently results in severe complications. We conducted a cohort study to identify prognostic factors and to establish a hepatolithiasis severity classification system.
Methods
The study cohort comprised 396 patients who were identified through a 1998 nationwide survey and followed up for 18 years or until death. Cox regression analysis was used to identify prognostic factors.
Results
Median survival time of the patients was 308 (range 0–462) months. Of the 396 patients enrolled in the study, 118 (29.8%) died, most frequently from intrahepatic cholangiocarcinoma (25 patients, 21.2%). Age of ≥ 65 years at the time of initial diagnosis [hazard ratio (HR) 3.410], jaundice for ≥ 1 week during follow-up (HR 2.442), intrahepatic cholangiocarcinoma (HR 3.674), and liver cirrhosis (HR 5.061) were shown to be significant risk factors for death from any therapeutic course. The data led to a 3-grade disease severity classification system that incorporates intrahepatic cholangiocarcinoma and liver cirrhosis as major factors and age of ≥ 65 years and jaundice for ≥ 1 week during follow-up as minor factors. Survival rates differed significantly between grades.
Conclusions
The proposed hepatolithiasis severity classification system can be used to assess prognosis and thereby improve patient outcomes.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>29119290</pmid><doi>10.1007/s00535-017-1410-6</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-2603-5688</orcidid></addata></record> |
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| subjects | Abdominal Surgery Analysis Biliary Tract Cholangiocarcinoma Cirrhosis Classification Cohort analysis Colorectal Surgery Diagnosis Gastroenterology Health aspects Hepatology Jaundice Liver Liver cirrhosis Medical prognosis Medical research Medicine Medicine & Public Health Medicine, Experimental Original Article—Liver Pancreas Patients Risk factors Surgical Oncology Surveys Survival |
| title | A proposed severity classification system for hepatolithiasis based on an analysis of prognostic factors in a Japanese patient cohort |
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