肝内胆管癌肝切除术后组织病理学预后因素的回顾性分析

Retrospective analysis of histopathologic prognostic factors after hepatectomy for intrahepatic cholangiocarcinoma.

作者信息

Jiang Bei-Ge, Sun Liang-Liang, Yu Wen-Long, Tang Zhao-Hui, Zong Ming, Zhang Yong-Jie

机构信息

Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, People's Republic of China.

出版信息

Cancer J. 2009 May-Jun;15(3):257-61. doi: 10.1097/PPO.0b013e31819e3312.

DOI:10.1097/PPO.0b013e31819e3312

PMID:19556914

Abstract

BACKGROUND

The aim of this study was to investigate histopathologic prognostic factors in patients with intrahepatic cholangiocarcinoma (ICC) whose tumors were resected to determine the optimal surgical strategies.

METHODS

One hundred and two ICC patients who underwent laparotomy from July 1998 to December 2000 were followed up successfully. Histopathologic variables were selected for univariate and multivariate analyses to evaluate their influence on the outcome.

RESULTS

The 1-, 3-, and 5-year survival rates after surgery were 56.9%, 25.5%, and 16.9%, respectively. The average survival duration was 21.91 +/- 20.17 months. In univariate analysis, the presence of lymph node (LN) metastasis, number of LNs with metastases, presence of intrahepatic metastasis, curative resection, and TNM stage were significant risk factors for survival. Multivariate analysis revealed that intrahepatic metastasis, noncurative resection, and TNM stage IVa were independent prognostic factors.

CONCLUSIONS

The histopathologic characteristics of intrahepatic metastasis were closely related to poor prognosis in ICC patients. Extensive hepatectomy with LN dissection may offer the only chance for long-term survival in patients with ICC.

摘要

背景

本研究旨在调查肝内胆管癌（ICC）患者的组织病理学预后因素，这些患者的肿瘤已被切除，以确定最佳手术策略。

方法

对1998年7月至2000年12月接受剖腹手术的102例ICC患者进行了成功随访。选择组织病理学变量进行单因素和多因素分析，以评估它们对预后的影响。

结果

术后1年、3年和5年生存率分别为56.9%、25.5%和16.9%。平均生存时间为21.91±20.17个月。单因素分析显示，淋巴结（LN）转移的存在、转移淋巴结的数量、肝内转移的存在、根治性切除和TNM分期是生存的重要危险因素。多因素分析显示，肝内转移、非根治性切除和TNM分期IVa是独立的预后因素。