Prognostic Value of Hepatocyte Growth Factor Receptor Expression in Patients with Perihilar Cholangiocarcinoma

Although an aggressive surgical approach to perihilar cholangiocarcinoma (PHC) has improved survival, a prognosis of advanced PHC remains unsatisfactory. The overexpression of mesenchymal-epithelial transition factor (MET) and recepteur d'origine nantais (RON) has been shown to be associated with poor prognosis in some types of cancer.

One hundred sixty-nine patients who underwent histologically curative resection for PHC were subjected to immunohistochemical analysis for MET and RON. The association between a positive expression of MET or RON and clinicopathologic features as well as the patients' prognosis were analyzed.

There were 27 patients (16 %) who had a positive expression for both MET and RON. Although clinicopathologic features in the either MET- or RON-negative group were not significantly different compared to the both MET- and RON-positive group, the prognosis tended to be worse in the patients with both MET and RON positivity. When the analysis was limited to patients with advanced-stage disease (stage III and IVa), a multivariate analysis revealed that both MET and RON positivity and lymph node metastasis were identified as independent poor prognostic factors.

The overall survival rate for patients with both MET and RON positivity was worse than that with either MET or RON negativity in patients with advanced PHC. The poor prognosis in these patients was not associated with unfavorable clinicopathologic features. The examination of MET and RON expression in PHC may enable a tailored method for patient classification that could not otherwise be achieved using the conventional pathologic classification system.