Chen Li-Ping, Li Chuan, Wang Chuan, Wen Tian-Fu, Yan Lu-Nan, Li Bo
Division of Liver and Vascular Surgery, West China Hospital, Sichuan University, Chengdu, China.
Hepatogastroenterology. 2012 Sep;59(118):1765-8. doi: 10.5754/hge11820.
BACKGROUND/AIMS: To identify risk factors related to postoperative recurrence for intrahepatic cholangiocarcinoma (ICC) patients with negative resection margin.
A total of 64 ICC patients who underwent resection with negative margin at our center from 2002 to 2010 were recruited in the present study. All clinicopathological characteristics were assessed using univariate analyses. Independent risk factors were identified by Cox regression. Factors significant at a p<0.10 in the univariate analyses were involved in the multivariate analyses. The diagnostic accuracy of the identified risk factors was evaluated using receiver operating curve (ROC).
The overall 1-, 3- and 5-year recurrence-free survival rates for patients with ICC were 63%, 32% and 27%, respectively. The most common site of postoperative recurrence was the liver. Lymph node metastasis, perineural invasion and total tumor size greater than 5 cm showed prognostic power in multivariate analysis. The recurrence-free survival rates reduced with the increasing of the number of risk factor for patients with ICC.
This study suggested liver was the most common recurrence site and confirmed lymph node metastasis, perineural invasion and total tumor size greater than 5 cm may be associated with poor outcome for ICC patients with negative resection margin.
背景/目的:确定肝内胆管癌(ICC)切缘阴性患者术后复发的相关危险因素。
本研究纳入了2002年至2010年在本中心接受切缘阴性切除术的64例ICC患者。所有临床病理特征均采用单因素分析进行评估。通过Cox回归确定独立危险因素。单因素分析中p<0.10有显著意义的因素纳入多因素分析。使用受试者工作特征曲线(ROC)评估所确定危险因素的诊断准确性。
ICC患者的1年、3年和5年无复发生存率分别为63%、32%和27%。术后最常见的复发部位是肝脏。多因素分析显示,淋巴结转移、神经周围侵犯和肿瘤总大小大于5 cm具有预后意义。ICC患者的无复发生存率随着危险因素数量的增加而降低。
本研究表明肝脏是最常见的复发部位,并证实淋巴结转移、神经周围侵犯和肿瘤总大小大于5 cm可能与ICC切缘阴性患者的不良预后相关。