Department of General Surgery, Third Xiangya Hospital of Central South University, No.138 of Tongzipo Road, Changsha 410013, China.
J Gastrointest Surg. 2011 Apr;15(4):608-13. doi: 10.1007/s11605-011-1419-8. Epub 2011 Jan 19.
The surgical outcome and prognostic factors of intrahepatic cholangiocarcinoma are not fully understood. This study aimed to establish the clinical significance of cirrhosis for prognosis in patients with intrahepatic cholangiocarcinoma after surgery.
One hundred fifteen patients with intrahepatic cholangiocarcinoma who underwent surgical resection between December 2001 and January 2008 were retrospectively analyzed. The prognostic significance of clinicopathologic factors including cirrhosis was assessed by univariate and multivariate analyses.
Thirty-two of the 115 patients (28%) had liver cirrhosis. Complete tumor removal (R0 resection) was performed in 42 patients (75%). Overall median survival time was 21 months, with 1-, 3-, and 5-year actuarial survival rates of 68%, 27%, and 17%, respectively. There was a significant difference in survival between patients with cirrhosis and those without cirrhosis (P = 0.027). Univariate analysis showed that cirrhosis, vascular invasion, hepatic duct invasion, lymph node metastasis, positive surgical margin (R1), and TNM stage were significantly associated with poor survival. Multivariate analysis showed that cirrhosis, positive surgical margin, and lymph node metastases were related to survival, with hazard ratios of 2.49, 3.53, and 4.16, respectively.
Cirrhosis is an independent factor for poor prognosis in intrahepatic cholangiocarcinoma after surgery.
肝内胆管细胞癌的手术结果和预后因素尚未完全明确。本研究旨在确定肝硬化对手术后肝内胆管细胞癌患者预后的临床意义。
回顾性分析 2001 年 12 月至 2008 年 1 月期间接受手术切除的 115 例肝内胆管细胞癌患者。通过单因素和多因素分析评估包括肝硬化在内的临床病理因素的预后意义。
115 例患者中有 32 例（28%）患有肝硬化。42 例患者（75%）行完全肿瘤切除（R0 切除）。总中位生存时间为 21 个月，1、3 和 5 年的生存率分别为 68%、27%和 17%。有肝硬化和无肝硬化患者的生存情况存在显著差异（P=0.027）。单因素分析显示，肝硬化、血管侵犯、胆管侵犯、淋巴结转移、阳性手术切缘（R1）和 TNM 分期与预后不良显著相关。多因素分析显示，肝硬化、阳性手术切缘和淋巴结转移与生存相关，风险比分别为 2.49、3.53 和 4.16。
肝硬化是肝内胆管细胞癌手术后预后不良的独立因素。
