Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Ann Surg Oncol. 2011 Mar;18(3):651-8. doi: 10.1245/s10434-010-1325-4. Epub 2010 Oct 14.
The prognosis of patients with cholangiocarcinoma is unsatisfactory. Therefore, evaluation of prognostic factors and establishment of new therapeutic strategies are needed to improve their long-term survival. The aim of this study was to identify useful prognostic factors for patients with intrahepatic, hilar, and distal cholangiocarcinoma.
Records of 127 patients with cholangiocarcinoma (21 with intrahepatic cholangiocarcinoma, 50 with hilar cholangiocarcinoma, and 56 with distal cholangiocarcinoma) who underwent surgical resection were reviewed retrospectively. Relationships between survival and clinicopathological factors including patient demographics and tumor characteristics were evaluated using univariate and multivariate analysis.
For all 127 patients, overall 1-, 3-, 5-year survival rates were 80, 51, and 40%, respectively. Univariate analysis revealed that adjuvant chemotherapy (P = .049), tumor differentiation (P = .014), lymph node metastasis (P < .001), surgical margin status (P < .001), UICC pT factor (P < .001), and UICC stage (P < .001) were associated significantly with survival. UICC pT factor (P = .007), adjuvant chemotherapy (P = .009), surgical margin status (P = .012), and lymph node metastasis (P = .014) remained independently associated with long-term survival by multivariate analysis. The 5-year survival rates of patients with or without positive surgical margins were 13 and 49%, respectively. The 5-year survival rates of patients treated with or without adjuvant chemotherapy were 47 and 36%, respectively.
R0 resection and adjuvant chemotherapy may be mandatory to achieve long-term survival for patients with cholangiocarcinoma.
胆管癌患者的预后并不理想。因此，需要评估预后因素并制定新的治疗策略，以提高其长期生存率。本研究旨在确定肝内、肝门和远端胆管癌患者的有用预后因素。
回顾性分析 127 例接受手术切除的胆管癌患者（21 例肝内胆管癌，50 例肝门部胆管癌，56 例远端胆管癌）的病历。采用单因素和多因素分析评估患者人口统计学和肿瘤特征与生存之间的关系。
所有 127 例患者的总 1 年、3 年和 5 年生存率分别为 80%、51%和 40%。单因素分析显示，辅助化疗（P=.049）、肿瘤分化程度（P=.014）、淋巴结转移（P<.001）、手术切缘状态（P<.001）、UICC pT 分期（P<.001）和 UICC 分期（P<.001）与生存显著相关。多因素分析显示，UICC pT 分期（P=.007）、辅助化疗（P=.009）、手术切缘状态（P=.012）和淋巴结转移（P=.014）仍然与长期生存独立相关。切缘阳性患者的 5 年生存率为 13%，切缘阴性患者的 5 年生存率为 49%。接受辅助化疗的患者 5 年生存率为 47%，未接受辅助化疗的患者 5 年生存率为 36%。
R0 切除和辅助化疗可能是胆管癌患者实现长期生存的必要条件。
