Han Sung-Sik, Jang Jin-Young, Lee Kuhn Uk, Kim Sun-Whe
Center for Liver Cancer, National Cancer Center, Goyang, Gyeonggi, Korea.
Hepatogastroenterology. 2008 Nov-Dec;55(88):1986-92.
BACKGROUND/AIMS: To analyze the actual long-term outcome of Klatskin's tumor after surgical resection and to identify the factors affecting long-term survival.
We reviewed the records of 145 Klatskin's tumor cases who underwent operation from 1991 to 1999 and analyzed the actual outcome and prognostic factors. We also compared the clinicopathologic characteristics of long-term and short-term survivors.
Seventy-six patients underwent resection (resection rate 52.4%). Twenty-one of the 76 patients survived more than 5 years, an actual 5-year survival rate of 28%, and of these survivors, 4 had recurrent disease at 5 years and 3 developed recurrence after 5 years. Five patients with well-known poor prognostic factors, such as, lymph node metastasis and resection margin involvement survived more than 5 years. Lymph node metastasis was identified as a significant prognostic factor, and long-term survivors were found to have more favorable T and N stages than short-term survivors.
The actual 5-year survival rate after resection was 28%, and lymph node metastasis was identified as a significant prognostic factor. Long-term follow-up is mandatory, because recurrence occurs beyond 5 years after surgery. An aggressive surgical approach should be used to give patients with poor prognostic factors a chance of survival.
背景/目的：分析手术切除后肝门部胆管癌的实际长期预后，并确定影响长期生存的因素。
我们回顾了1991年至1999年接受手术的145例肝门部胆管癌病例的记录，分析了实际预后和预后因素。我们还比较了长期和短期幸存者的临床病理特征。
76例患者接受了切除手术（切除率52.4%）。76例患者中有21例存活超过5年，实际5年生存率为28%，在这些幸存者中，4例在5年时出现复发，3例在5年后复发。5例具有众所周知的不良预后因素（如淋巴结转移和切缘受累）的患者存活超过5年。淋巴结转移被确定为一个重要的预后因素，并且发现长期幸存者比短期幸存者具有更有利的T和N分期。
切除术后实际5年生存率为28%，淋巴结转移被确定为一个重要的预后因素。必须进行长期随访，因为复发发生在手术后5年以上。对于具有不良预后因素的患者，应采用积极的手术方法以给予其生存机会。
