Uenishi T, Hirohashi K, Kubo S, Yamamoto T, Hamba H, Tanaka H, Kinoshita H
Second Department of Surgery, Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan.
World J Surg. 2001 Jul;25(7):865-9. doi: 10.1007/s00268-001-0042-3.
Long-term survival following hepatectomy for intrahepatic cholangiocarcinoma has been poor, and specific factors influencing survival are unclear. In a retrospective study we sought to determine prognostic factors related to survival in these patients. In 28 patients who underwent hepatic resection for intrahepatic cholangiocarcinoma, we investigated the relations of several histologic factors to patient survival by univariate and multivariate analyses. No deaths occurred during the first 30 days. Median and mean survival times following hepatectomy were 409 and 935 days, respectively. The respective survival rates at 1, 3, and 5 years were 57%, 27%, and 27%. Resection margin status, intrahepatic metastasis, lymph node involvement, and lymphatic invasion were significant predictors of outcome. In a multivariate analysis using the Cox proportional hazards model, only lymphatic invasion independently predicted survival. Curative resection with clear margins was found to prolong survival after surgery. Hepatectomy for intrahepatic cholangiocarcinoma without lymphatic invasion offers hope for long-term survival.
肝内胆管癌肝切除术后的长期生存率一直很低，影响生存的具体因素尚不清楚。在一项回顾性研究中，我们试图确定这些患者生存的预后因素。在28例行肝内胆管癌肝切除术的患者中，我们通过单因素和多因素分析研究了几种组织学因素与患者生存的关系。术后30天内无死亡病例。肝切除术后的中位生存时间和平均生存时间分别为409天和935天。1年、3年和5年的生存率分别为57%、27%和27%。切缘状态、肝内转移、淋巴结受累和淋巴管侵犯是预后的重要预测因素。在使用Cox比例风险模型的多因素分析中，只有淋巴管侵犯独立预测生存。切缘阴性的根治性切除可延长术后生存期。无淋巴管侵犯的肝内胆管癌肝切除术为长期生存带来了希望。
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