Faculty of Medicine, Universiti Tekno-logi MARA, Sg. Buloh Campus, 47000 Sg. Buloh, Selangor, Malaysia.
World J Gastroenterol. 2012 Feb 7;18(5):458-65. doi: 10.3748/wjg.v18.i5.458.
To investigate the clinical features and survival of patients treated for cholangiocarcinoma in our institution and to analyze the factors affecting their survival.
This retrospective cohort study assessed patients diagnosed with cholangiocarcinoma between January 1997 and December 2007 at the University Malaya Medical Centre in Malaysia. The clinical data and associated outcomes were collected using a structured proforma.
Of the 69 patients diagnosed with cholangiocarcinoma, 38 (55%) were male; mean patient age was 61 years. Twelve patients (17%) had intrahepatic, 38 (55%) had perihilar and 19 (28%) had distal tumors. Only 12 patients underwent curative surgery, including seven R0 resections. Only one patient died within 30 d after surgery. The overall median survival was 4 mo, whereas the median survival of R0 resected patients was 16 mo. The overall 1-, 2- and 3-year cumulative survival rates were 67%, 17% and 17%, respectively. Survival rates were significantly associated with curative resection (P = 0.002), intrahepatic tumor (P = 0.003), negative margin status (P = 0.013), early tumor stage (P = 0.016), higher tumor differentiation (P = 0.032) and absence of jaundice (P = 0.038). Multivariate analysis showed that tumor location was a significant independent predictor of patient survival.
Curative, margin-negative resection of early stage, well-differentiated intrahepatic tumors is associated with improved patient survival.
研究本机构治疗胆管癌患者的临床特征和生存情况，并分析影响其生存的因素。
本回顾性队列研究评估了 1997 年 1 月至 2007 年 12 月在马来西亚马来亚大学医学中心诊断为胆管癌的患者。使用结构化表格收集临床数据和相关结局。
在 69 例诊断为胆管癌的患者中，38 例（55%）为男性；平均患者年龄为 61 岁。12 例（17%）为肝内肿瘤，38 例（55%）为肝门周围肿瘤，19 例（28%）为远端肿瘤。仅 12 例患者接受了根治性手术，包括 7 例 R0 切除术。仅 1 例患者术后 30d 内死亡。总中位生存期为 4 个月，而 R0 切除患者的中位生存期为 16 个月。总的 1 年、2 年和 3 年累积生存率分别为 67%、17%和 17%。生存情况与根治性切除（P=0.002）、肝内肿瘤（P=0.003）、阴性切缘状态（P=0.013）、早期肿瘤分期（P=0.016）、较高的肿瘤分化程度（P=0.032）和无黄疸（P=0.038）显著相关。多变量分析显示，肿瘤部位是患者生存的显著独立预测因素。
早期、高分化、肝内肿瘤的根治性、阴性切缘切除术与改善患者生存相关。
