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临床病理因素影响肝癌合并胆管细胞癌切除术后的生存结局。

Clinicopathological factors impact the survival outcome following the resection of combined hepatocellular carcinoma and cholangiocarcinoma.

机构信息

Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.

出版信息

Surg Oncol. 2013 Mar;22(1):55-60. doi: 10.1016/j.suronc.2012.09.003. Epub 2012 Oct 24.

Abstract

Studies have demonstrated poor survival outcomes for patients with resected combined hepatocellular carcinoma-cholangiocarcinoma tumours (CHCC-CC). Our objectives are to report on our institutional experience regarding the clinico-pathological and prognostic features of CHCC-CC and to compare our results with published series. The clinico-pathological features and outcomes of 11 patients with CHCC-CC who had a complete surgical resection for primary liver cancer were reviewed. There were 8 male and 3 female patients. The overall median age was 61 years. Active hepatitis B and hepatitis C infections were present in 6 (54%) and 2 (18%) patients, respectively. Alcoholism was present in one case. Cirrhosis was present in 8 (72%) cases. There were no causative factors identified in 2 patients with non-cirrhotic livers. The median AFP value was 30.56 ng/ml. A single mass located in the right lobe and a single mass located in the left lobe of the liver was noted in 6 (54%) and 4 (36%) patients, respectively. Bilobar involvement was observed in one case. Major and minor resections were performed in 2 (18%) and 9 (81%) cases, respectively. The median tumour size was 3 cm. Tumours measuring >5 cm were identified in only 2 (18%) cases. The majority of the cases were classified as stage I (54%) and stage II (36%). Four patients died 11-50 months after the surgery. Postoperative tumour recurrences were observed in 5 (45.45%) patients within 4 years of surgical resection. The overall 1- and 3-year survival rates in this series were 80% and 69.3%. Our series demonstrated cases of CHCC-CC with more favourable pathological traits and survival outcomes compared with similar studies.

摘要

研究表明,接受肝切除联合肝细胞癌-胆管细胞癌(CHCC-CC)肿瘤治疗的患者生存结果较差。我们的目标是报告我们机构在 CHCC-CC 的临床病理和预后特征方面的经验,并将我们的结果与已发表的系列进行比较。回顾了 11 例接受原发性肝癌完全手术切除的 CHCC-CC 患者的临床病理特征和结果。8 例为男性,3 例为女性。患者的总体中位年龄为 61 岁。6 例(54%)患者存在乙型和丙型肝炎病毒的活动性感染,2 例(18%)患者存在丙型肝炎病毒感染。1 例患者有酒精中毒史。8 例(72%)患者存在肝硬化。2 例非肝硬化患者未发现病因。中位 AFP 值为 30.56ng/ml。6 例(54%)患者的肿瘤位于右叶,4 例(36%)患者的肿瘤位于左叶,1 例患者的肿瘤累及两叶。2 例(18%)患者接受了大切除术,9 例(81%)患者接受了小切除术。肿瘤的中位大小为 3cm。仅 2 例(18%)患者的肿瘤大小>5cm。大多数病例被分为 I 期(54%)和 II 期(36%)。4 例患者在手术后 11-50 个月死亡。术后肿瘤复发发生在 5 例(45.45%)患者中,发生在手术切除后 4 年内。在本系列中,患者的 1 年和 3 年总生存率分别为 80%和 69.3%。与类似研究相比,我们的系列研究显示 CHCC-CC 病例具有更有利的病理特征和生存结果。

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