Havlik R, Sbisà E, Tullo A, Kelly M D, Mitry R R, Jiao L R, Mansour M R, Honda K, Habib N A
Liver Surgery Section, Imperial College School of Medicine, Hammersmith Hospital, London, UK.
Hepatogastroenterology. 2000 Jul-Aug;47(34):927-31.
BACKGROUND/AIMS: Resection for hilar cholangiocarcinoma remains a challenging procedure and recent published results continue to show that few patients are cured of their disease. The objective of this review was to determine the results of radical resection and to identify factors associated with long-term survival.
Retrospective review of resection for hilar cholangiocarcinoma in 29 consecutive patients with statistical analysis of prognostic factors, including p53 status.
The mortality and morbidity rates were 6.9% and 34%, respectively. The overall 5-year survival was 20% with the median survival being 16 months. Univariate analysis identified the following factors associated with poor survival; involved lymph nodes, vascular invasion, advanced tumor stage, positive tumor margins, and p53 mutation. However, none of these factors was associated with poor survival by multivariate analyses.
Radical resection for hilar cholangiocarcinoma can be performed with acceptable morbidity and mortality, but most patients succumb to their disease. p53 status may be a helpful adjunct to routine pathological staging.
背景/目的：肝门部胆管癌切除术仍然是一项具有挑战性的手术，最近公布的结果继续表明，很少有患者能治愈该疾病。本综述的目的是确定根治性切除的结果，并确定与长期生存相关的因素。
回顾性分析连续29例肝门部胆管癌切除术患者，并对包括p53状态在内的预后因素进行统计分析。
死亡率和发病率分别为6.9%和34%。总体5年生存率为20%，中位生存期为16个月。单因素分析确定了以下与生存不良相关的因素：淋巴结受累、血管侵犯、肿瘤分期较晚、肿瘤切缘阳性和p53突变。然而，多因素分析显示这些因素均与生存不良无关。
肝门部胆管癌根治性切除可以在可接受的发病率和死亡率下进行，但大多数患者最终死于该疾病。p53状态可能有助于常规病理分期。
