Paik Kwang Yeol, Jung Jun Chul, Heo Jin Seok, Choi Seong Ho, Choi Dong Wook, Kim Yong Il
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Gastroenterol Hepatol. 2008 May;23(5):766-70. doi: 10.1111/j.1440-1746.2007.05040.x. Epub 2007 Sep 12.
Our aim was to evaluate the predictive factors for survival and disease-free survival of patients with resected intrahepatic cholangiocarcinoma (ICC).
Between October 1994 and 2005, 97 patients with ICC underwent curative hepatic resection. The tumors in 97 patients were reviewed retrospectively to examine the prognosis of ICC.
The 1-, 3- and 5-year survival rates were 74.9%, 51.8% and 31.1%, respectively. The 1-, 3- and 5-year disease-free survival rates were 21.3%, 6.4% and 2.1%, respectively. Univariate analysis showed that tumor size, tumor number, the gross type, resection margin status, T-stage and lymph node involvement were significant prognostic factors. Multiple tumors and cancer cells in the resection margin were found in multivariate analysis to be significantly related to the prognosis. In the multivariate analysis disease free survival was poor for the patients with a large tumor, multiple lesions, a high CA 19-9 level, cancer in the resection margin, advanced T-stage and lymph node involvement.
The overall 5-year survival rate of ICC was 31.1%. Multiple intrahepatic lesions were a sign of a poor prognosis for ICC. Better survival could be achieved by curative resection with a tumor-free margin.
我们的目的是评估肝内胆管癌（ICC）切除术后患者生存及无病生存的预测因素。
1994年10月至2005年期间，97例ICC患者接受了根治性肝切除术。对97例患者的肿瘤进行回顾性分析以研究ICC的预后。
1年、3年和5年生存率分别为74.9%、51.8%和31.1%。1年、3年和5年无病生存率分别为21.3%、6.4%和2.1%。单因素分析显示肿瘤大小、肿瘤数量、大体类型、切缘状态、T分期及淋巴结受累是显著的预后因素。多因素分析发现多发肿瘤及切缘癌细胞与预后显著相关。多因素分析中，肿瘤体积大、病变多发、CA 19-9水平高、切缘有癌、T分期晚及淋巴结受累的患者无病生存较差。
ICC患者总体5年生存率为31.1%。肝内多发病变是ICC预后不良的征象。切缘无肿瘤的根治性切除可获得更好的生存。
